Effects of Acute Triiodothyronine Treatment in Patients with Anterior Myocardial Infarction Undergoing Primary Angioplasty: Evidence from a Pilot Randomized Clinical Trial (ThyRepair Study)

Pantos, Constantinos; Trikas, Athanasios; Pisimisis, E; Grigoriou, Konstantinos; Stougiannos, Pavlos; Dimopoulos, Antonios; Linardakis, Sarantos; Alexopoulos, Nikolaos; Evdoridis, Costas G; Gavrielatos, Gerasimos; Patsourakos, Nikolaos G.; Papakonstantinou, Nikolaos D; Theodosis‐Georgilas, Anastasios; Mourouzis, Iordanis

doi:10.1089/thy.2021.0596

Cited by 16 publications

(17 citation statements)

References 34 publications

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“…In this context, experimental and clinical evidence signals for further investigation of the potential use of TH in sepsis and particularly COVID-19. Favorable effects of acute LT3 treatment have recently been reported in patients with myocardial infarction (Thy-Repair) without major adverse effects [6].…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with the experimental evidence, this study showed that LT3 can prevent dilatation of the left ventricle (LV), electrical remodeling and can also improve infarct healing, without any major adverse effects. A favorable effect on microvascular obstruction (MVO) was also observed [6]. In addition, early T3 administration in by-pass surgery was shown to improve cardiac function and limit troponin release, too [56].…”

Section: Th As Potential Therapy For Tissue Hypoxiamentioning

confidence: 97%

“…Despite the limited number of patients included in the first interim analysis, important novel findings were observed, which warrant further investigation in future clinical trials. In this clinical setting, LT3 was used in a similar therapeutic regimen as in patients with myocardial infarction [6], and baseline patient details have been previously reported [76]. Preliminary data from the Thy-Support study showed that LT3 treatment of ICU COVID-19 patients resulted in an acute drop in the ESR within 48 h of its administration along with a trend of a decrease in troponin levels [76].…”

Section: Th Therapy In Severe Covid-19: Preliminary Clinical Evidencementioning

confidence: 99%

“…Accordingly, TH administration in a dose-dependent manner prevented cardiac remodeling in experimental models of myocardial infarction [55]. This experimental evidence was recently translated into a pilot randomized clinical trial (Thy-Repair) which investigated the effects of early high-dose L-triiodothyronine (LT3) in patients with anterior MI undergoing primary angioplasty [6]. In accordance with the experimental evidence, this study showed that LT3 can prevent dilatation of the left ventricle (LV), electrical remodeling and can also improve infarct healing, without any major adverse effects.…”

Section: Th As Potential Therapy For Tissue Hypoxiamentioning

confidence: 99%

“…Tissue hypoxia due to disturbed microcirculation seems to be a unifying pathophysiologic mechanism in a spectrum of clinical conditions such as myocardial infarction, sepsis and trauma [3]. In this context, TH signaling is shown to be implicated in hypoxia-induced cardiac remodeling [4] and T3 therapy has favorable effects on postischemic cardiac function and infarct healing both in experimental studies and in humans [5,6]. Along this line, T3 has recently been shown to prevent tissue hypoxia in experimental sepsis [7].…”

Section: Introductionmentioning

confidence: 99%

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The Potential of Thyroid Hormone Therapy in Severe COVID-19: Rationale and Preliminary Evidence

Mourouzis

Apostolaki

Trikas

et al. 2022

IJERPH

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Tissue hypoxia is one of the main pathophysiologic mechanisms in sepsis and particularly in COVID-19. Microvascular dysfunction, endothelialitis and alterations in red blood cell hemorheology are all implicated in severe COVID-19 hypoxia and multiorgan dysfunction. Tissue hypoxia results in tissue injury and remodeling with re-emergence of fetal programming via hypoxia-inducible factor-1α (HIF-1a)-dependent and -independent pathways. In this context, thyroid hormone (TH), a critical regulator of organ maturation, may be of relevance in preventing fetal-like hypoxia-induced remodeling in COVID-19 sepsis. Acute triiodothyronine (T3) treatment can prevent cardiac remodeling and improve recovery of function in clinical settings of hypoxic injury as acute myocardial infarction and by-pass cardiac surgery. Furthermore, T3 administration prevents tissue hypoxia in experimental sepsis. On the basis of this evidence, the use of T3 treatment was proposed for ICU (Intensive Care Unit) COVID-19 patients (Thy-Support, NCT04348513). The rationale for T3 therapy in severe COVID-19 and preliminary experimental and clinical evidence are discussed in this review.

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Section: Discussionmentioning

confidence: 99%

Section: Th As Potential Therapy For Tissue Hypoxiamentioning

confidence: 97%