Free triiodothyronine and global registry of acute coronary events risk score on predicting long-term major adverse cardiac events in STEMI patients undergoing primary PCI

Chang, Xin; Zhang, Shouyan; Zhang, Mingming; Wang, Hao; Fan, Caifeng; Gu, Yuanjun; Ji, Wei; Qiu, Chunguang

doi:10.1186/s12944-018-0881-7

Cited by 12 publications

(11 citation statements)

References 34 publications

(42 reference statements)

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“… 42 In STEMI patients undergoing PCI it was observed that low fT3 was an independent marker for MACE. 44 A small sample study has demonstrated an association of abnormal THs alterations with worse prognosis. 4 Short term and long-term mortality have been related with the low T3 syndrome in patients undergoing primary percutaneous coronary angioplasty for STEMI, 30 , 45 Even in patients recovering after ACS and undergoing a cardiac rehabilitation program have reported an association of lower fT3 levels with mortality.…”

Section: The Prognostic Value Of Thyroid Dysfunction In Acsmentioning

confidence: 99%

“… Lymvaios et al. 44 2011 Prospective AMI 47 At 24 h, 48 h, 5 days and 6 months 6 months Lower T3 levels are associated with poor early and late myocardial functional recovery Xue et al. 22 2017 Prospective ACS Patient treated with drug-eluting stent 528 From 24 h to 48 h after admission 1 year A low fT3 level is a predictor of worse HRQOL improvement in ACS patients treated with DES.…”

Section: The Prognostic Value Of Thyroid Dysfunction In Acsmentioning

confidence: 99%

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Prognostic implications of thyroid hormone alterations in acute coronary syndrome–A systematic review

Arambam

Kaul

Ranjan

et al. 2021

Indian Heart Journal

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There is considerable association of thyroid function and the cardiovascular system during various acute systemic illnesses. It is well established that the normal thyroid homeostasis is known to alter in disease states including the acute coronary syndromes (ACS). Abnormal thyroid hormonal status has been shown to be related to worse outcomes and prognosis. This review focuses on the relationship of alterations in thyroid function and its influence on the pathophysiological mechanisms and cardiovascular hemodynamics in ACS and based upon the literature, summarises all the existing evidence to this date on this subject. The data largely points out that low levels of triiodothyronine (T3) levels seen in ACS might be useful in prognosticating the outcomes of ACS.

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Section: The Prognostic Value Of Thyroid Dysfunction In Acsmentioning

confidence: 99%

Section: The Prognostic Value Of Thyroid Dysfunction In Acsmentioning

confidence: 99%

Prognostic implications of thyroid hormone alterations in acute coronary syndrome–A systematic review

Arambam

Kaul

Ranjan

et al. 2021

Indian Heart Journal

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“…In seriously ill COVID-19 patients, serum fT3 concentrations were lower than expected and independently predicted all-cause mortality in this cluster of patients [73]. The low T3 syndrome is commonly observed in several acute and chronic clinical conditions such as in sepsis [74], myocardial infarction [75], and chronic heart failure [76,77], and is the result of an adaptive mechanism whose severity is related to the levels of systemic inflammation [78], serum circulating cortisol, and disturbance of peripheral thyroid hormone transport and metabolism [79]. Normal circulating T3 levels are essential to maintain myocardial tropism [80] and antiinflammatory effects by reducing peripheral immune cells' recruitment and attenuating the immune system hyperactivation in response to endotoxemia [81].…”

Section: Could Medical Management Of Thyroid Diseases Influence the Clinical Course Of Covid-19?mentioning

confidence: 71%

Thyroid and COVID-19: a review on pathophysiological, clinical and organizational aspects

Lisco

Tullio

Jirillo

et al. 2021

J Endocrinol Invest

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Background Thyroid dysfunction has been observed in patients with COVID-19, and endocrinologists are requested to understand this clinical issue. Pandemic-related restrictions and reorganization of healthcare services may affect thyroid disease management. Objective and methods To analyze and discuss the relationship between COVID-19 and thyroid diseases from several perspectives. PubMed/MEDLINE, Google Scholar, Scopus, ClinicalTrial.gov were searched for this purpose by using free text words and medical subject headings as follows: “sars cov 2”, “covid 19”, “subacute thyroiditis”, “atypical thyroiditis”, “chronic thyroiditis”, “hashimoto’s thyroiditis”, “graves’ disease”, “thyroid nodule”, “differentiated thyroid cancer”, “medullary thyroid cancer”, “methimazole”, “levothyroxine”, “multikinase inhibitor”, “remdesivir”, “tocilizumab”. Data were collected, analyzed, and discussed to answer the following clinical questions: “What evidence suggests that COVID-19 may induce detrimental consequences on thyroid function?"; "Could previous or concomitant thyroid diseases deteriorate the prognosis of COVID-19 once the infection has occurred?”; “Could medical management of thyroid diseases influence the clinical course of COVID-19?”; “Does medical management of COVID-19 interfere with thyroid function?”; “Are there defined strategies to better manage endocrine diseases despite restrictive measures and in-hospital and ambulatory activities reorganizations?”. Results SARS-CoV-2 may induce thyroid dysfunction that is usually reversible, including subclinical and atypical thyroiditis. Patients with baseline thyroid diseases are not at higher risk of contracting or transmitting SARS-CoV-2, and baseline thyroid dysfunction does not foster a worse progression of COVID-19. However, it is unclear whether low levels of free triiodothyronine, observed in seriously ill patients with COVID-19, may worsen the disease's clinical progression and, consequently, if triiodothyronine supplementation could be a tool for reducing this burden. Glucocorticoids and heparin may affect thyroid hormone secretion and measurement, respectively, leading to possible misdiagnosis of thyroid dysfunction in severe cases of COVID-19. High-risk thyroid nodules require a fine-needle aspiration without relevant delay, whereas other non-urgent diagnostic procedures and therapeutic interventions should be postponed. Discussion Currently, we know that SARS-CoV-2 could lead to short-term and reversible thyroid dysfunction, but thyroid diseases seem not to affect the progression of COVID-19. Adequate management of patients with thyroid diseases remains essential during the pandemic, but it could be compromised because of healthcare service restrictions. Endocrine care centers should continuously recognize and classify priority cases for in-person visits and therapeutic procedures. Telemedicine may be a useful tool for managing patients not requiring in-person visits.

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“…In addition, D. H. Kim et al [29] reported that in STEMI patients, the degree of transmural involvement accessed by contrast-enhanced cardiac magnetic res-onance (CMR) imaging is strongly correlated with T3 levels. Chang et al [30] demonstrated that low FT3 levels was an independent indicator of long-term worse prognosis in STEMI patients undergoing PCI. Other studies also found that low T3 levels have been correlated with short and long-term mortality in STEMI patients undergoing PCI [9,31].…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Free Triiodothyronine in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Yang¹,

Teng²,

Shao³

et al. 2022

Rev. Cardiovasc. Med.

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Background: Homeostasis of thyroid hormones has significant effects on the cardiovascular system. The aim of this study was to investigate the association between free triiodothyronine (FT3) and adverse cardiovascular events in patients with acute coronary syndrome (ACS) who were undergoing percutaneous coronary intervention (PCI). Methods: A total of 1701 patients with ACS undergoing PCI were included in this study. All patients were divided into three groups according to the tertiles of FT3 level: the lowest tertile (FT3 <4.51 pmol/L), the middle tertile (4.51 pmol/L ≤ FT3 < 4.89 pmol/L) and the highest tertile group (FT3 ≥4.89 pmol/L). The primary study endpoint was a composite of major adverse cardiovascular events (MACE), which included all-cause death, ischemic stroke, myocardial infarction, or unplanned repeat revascularization. Results: During a median follow-up period of 927 days, 349 patients had at least one event. Compared with patients with the highest tertile, those with the lowest tertile had a significantly higher incidence of MACE, all-cause death, MI, ischemic stroke and repeat revascularization (all p values < 0.05). In the multivariate Cox regression analysis, the middle tertile had similar risk of MACE (HR = 0.986, 95% CI 0.728-1.336, p = 0.929) as the highest tertile, but the patients with the lowest tertile had a 92.9% higher risk of MACE (HR = 1.929, 95% CI 1.467-2.535, p < 0.001). There was a non-linear relationship between FT3 and MACE and unplanned repeat revascularization (all p values for non-linear association <0.001). Adding the tertiles of FT3 level into the baseline model yielded a significant improvement in discrimination for predicting MACE (∆AUC = 0.013, p = 0.025). Conclusions: A significantly reduced FT3 level was independently associated with a worse prognosis in patients with ACS undergoing PCI.

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Free triiodothyronine and global registry of acute coronary events risk score on predicting long-term major adverse cardiac events in STEMI patients undergoing primary PCI

Cited by 12 publications

References 34 publications

Prognostic implications of thyroid hormone alterations in acute coronary syndrome–A systematic review

Prognostic implications of thyroid hormone alterations in acute coronary syndrome–A systematic review

Thyroid and COVID-19: a review on pathophysiological, clinical and organizational aspects

Predictive Value of Free Triiodothyronine in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

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