Prognostic Value of Thyroid Hormone Levels in Acute Myocardial Infarction: Just an Epiphenomenon?

Satar, Salim; Seydaoğlu, Gülşah; Avcı, Akkan; Sebe, Ahmet; Karcıoğlu, Özgür; Topal, Metin

doi:10.1111/j.1541-9215.2005.04653.x

Cited by 9 publications

(7 citation statements)

References 28 publications

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“…The conclusion was that triiodothyronine and lower free thyroxine appeared to be independent prognostic factors in patients with AMI. 1 In our study, we showed a trend towards higher levels of troponin and TSH. However, correlation until this moment was not significant.…”

Section: Discussionsupporting

confidence: 58%

“…Another study 1 in 2005 investigated whether thyroid hormone levels had any predictive value for mortality in patients presenting to the emergency department with AMI. Three groups of patients admitted to the emergency department within the 11-month study period: 95 patients with chest pain and diagnosed AMI; 26 patients with chest pain and no AMI; and 114 controls with no evidence of any major disease.…”

Section: Discussionmentioning

confidence: 99%

“…The cardiovascular system is very sensitive to thyroid hormones, and a wide spectrum of cardiac changes has long been recognized in overt thyroid dysfunction. 1 - 3 …”

Section: Introductionmentioning

confidence: 99%

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Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?

Soeiro¹,

Araújo²,

Vella³

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundSome small studies have related higher levels of thyrotropin (TSH) to potentially worse prognosis in acute coronary syndromes. However, this relationship remains uncertain.ObjectiveTo analyze the outcomes of patients with acute coronary syndromes in relation to the value of TSH at admission.MethodsObservational and retrospective study with 505 patients (446 in group I [TSH ≤ 4 mIU/L] and 59 in group II [TSH > 4 mIU/L]) with acute coronary syndromes between May 2010 and May 2014. We obtained data about comorbidities and the medications used at the hospital. The primary endpoint was in-hospital all-cause death. The secondary endpoint included combined events (death, non-fatal unstable angina or myocardial infarction, cardiogenic shock, bleeding and stroke). Comparisons between groups were made by one-way ANOVA and chi-square test. Multivariate analysis was determined by logistic regression. Analyses were considered significant when p < 0.05.ResultsSignificant differences between groups I and II were observed regarding the use of enoxaparin (75.2% vs. 57.63%, p = 0.02) and statins (84.08% vs. 71.19%, p < 0.0001), previous stroke (5.83% vs. 15.25%, p = 0.007), combined events (14.80% vs. 27.12%, OR = 3.05, p = 0.004), cardiogenic shock (4.77% vs. 6.05%, OR = 4.77, p = 0.02) and bleeding (12.09% vs. 15.25%, OR = 3.36, p = 0.012).ConclusionsIn patients with acute coronary syndromes and TSH > 4 mIU/L at admission, worse prognosis was observed, with higher incidences of in-hospital combined events, cardiogenic shock and bleeding.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?

Soeiro¹,

Araújo²,

Vella³

et al. 2018

Arquivos Brasileiros De Cardiologia

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“…Independent of time-course, type and severity, a low T3 state may serve as an adaptive mechanism which reduces metabolic demands by reducing the catabolic processes of the disease 8 . A low T3 syndrome was a frequent finding in patients with cardiac pathology and without a history of thyroid dysfunction, particularly among patients with HF, AMI, and those following cardiac surgery [15][16][17][62][63][64][65] . However, the exact point of occurrence of THs alterations, after an ACS, is not clearly understood 2,[66][67][68] .…”

Section: Discussionmentioning

confidence: 99%

Importance of Thyroid Hormone level and Genetic Variations in Deiodinases for Patients after Acute Myocardial Infarction: A Longitudinal Observational Study

Kažukauskienė

Skiriutė

Gustienė

et al. 2020

Sci Rep

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This study aimed to examine the influence of thyroid hormone (TH) levels and genetic polymorphisms of deiodinases on long-term outcomes after acute myocardial infarction (AMI). In total, 290 patients who have experienced AMi were evaluated for demographic, clinical characteristics, risk factors, tH and NT-pro-BNP. Polymorphisms of TH related genes were included deiodinase 1 (DIO1) (rs11206244-C/T, rs12095080-A/G, rs2235544-A/C), deiodinase 2 (DIO2) (rs225015-G/A, rs225014-T/C) and deiodinase 3 (DIO3) (rs945006-T/G). Both all-cause and cardiac mortality was considered key outcomes. Cox regression model showed that NT-pro-BNP (HR = 2.11; 95% CI = 1.18-3.78; p = 0.012), the first quartile of fT3, and DIO1 gene rs12095080 were independent predictors of cardiac-related mortality (HR = 1.74; 95% CI = 1.04-2.91; p = 0.034). The DIO1 gene rs12095080 AG genotype (OR = 3.97; 95% ci = 1.45-10.89; p = 0.005) increased the risk for cardiac mortality. Lower fT3 levels and the DIO1 gene rs12095080 are both associated with cardiac-related mortality after AMI. Recent clinical research in cardiovascular disease as well as in coronary artery disease (CAD) has provided evidence that altered thyroid hormone (TH) metabolism, including low total triiodothyronine (T3) syndrome or pre-existing subclinical primary hypothyroidism, is an important indicator of adverse short-term and long-term outcomes, including mortality 1-5. These changes in thyroid homeostasis are known as "euthyroid sick syndrome" 6,7 or "non-thyroidal illness syndrome" (NTIS) 8,9 and are defined by low serum levels of free T3 (fT3), T3 and high levels of reverse T3 (rT3) followed by normal or low levels of thyroxine (T4) and thyroid-stimulating hormone (TSH). Low T3 syndrome is observed in about one third of patients following acute cardiovascular events and has been linked to the severity of the disease and its adverse prognosis 10. This syndrome has been established in patients with heart failure (HF) 11-14 , myocardial infarction (MI) 2,15-18 , and has been linked to the cardiac remodelling process 19-21 and poor prognosis 1,3,4,13,22,23. Studies suggest that variations of TH within clinically normal ranges, such as isolated reduction in fT3 level or higher level of free T4 (fT4), could constitute a model of abnormal TH metabolism. These variations could act as a risk factor for CAD, in a similar fashion to overt or subclinical hypothyroidism, thereby influencing the occurrence as well as severity of coronary atherosclerosis and its related outcomes 2,24-32 .

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“…The times and duration of hospitalization were also hypothesized to reflect the severity of the disease to some extent; hospitalization time was longer among survivors (7.46±4.01 days) compared to non-survivors (6.86±3.30) ( 36 ). However, no significant correlations of prognosis with times of hospitalization and duration of hospital stay were identified.…”

Section: Discussionmentioning

confidence: 99%

Association of various risk factors with prognosis and hospitalization cost in Chinese patients with acute myocardial infarction: A clinical analysis of 627 cases

Wang

Zhou

Jin

et al. 2014

Experimental and Therapeutic Medicine

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Acute myocardial infarction (AMI) is the leading cause of morbidity and mortality in the developed world and is becoming increasingly more common in developing countries. The risk factors affecting the prognosis of Chinese patients may differ from those in other populations. This study was conducted to investigate the potential risk factors that may correlate with prognosis and hospitalization costs of Chinese AMI patients. A total of 627 hospitalized AMI patients were recruited and their general information and relevant laboratory parameters were collected. Accordingly, the patients were grouped into different subgroups and potential risk factors and their correlations with prognosis and hospitalization costs were analyzed. Age, high blood pressure, infarct location and percutaneous coronary intervention (PCI) were the variables significantly associated with the differences in the prognosis of AMI patients (P<0.05), whereas times and duration of hospitalization, high blood pressure, infarct location and PCI treatment were found to be significantly associated with the cost of hospitalization (P<0.05). However, the AMI patients enrolled in this study may not be representative of all AMI patients in China. In addition, the prognosis of these patients was limited to their hospital stay. Therefore, long-term follow-up requires careful assessment.

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Prognostic Value of Thyroid Hormone Levels in Acute Myocardial Infarction: Just an Epiphenomenon?

Cited by 9 publications

References 28 publications

Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?

Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?

Importance of Thyroid Hormone level and Genetic Variations in Deiodinases for Patients after Acute Myocardial Infarction: A Longitudinal Observational Study

Association of various risk factors with prognosis and hospitalization cost in Chinese patients with acute myocardial infarction: A clinical analysis of 627 cases

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