ObjectivesThe present study assessed the changes in functional, biochemical, and echocardiographic measures following long‐term liothyronine therapy in heart failure (HF) patients with low‐triiodothyronine (T3) syndrome (LT3S).MethodsIn the present placebo‐controlled, double‐blind study, adult patients with clinically stable New York Heart Association functional class I–III systolic HF and LT3S receiving standard HF therapy were randomly assigned 1:1 to receive oral liothyronine or placebo for 6 weeks. Low‐T3 syndrome was defined as a serum free T3 of less than the lower limit of normal (<2.4 pg/mL) with normal thyroid‐stimulating hormone (thyrotropin) and free thyroxin values.ResultsFifty patients, including 39 (78%) men with a mean ± standard deviation age of 60 ± 15 years were included. The 6‐min walk distance increased in the liothyronine group by 93 ± 16 m and in the placebo group by 67 ± 28 m, resulting in a treatment effect of 26 m (P = 0.003). A higher decrease of high‐sensitivity C‐reactive protein level was seen in the liothyronine group than in the placebo group (P = 0.009). Liothyronine markedly decreased serum N‐terminal pro‐brain natriuretic peptide level compared with the placebo (P = 0.01). A significant increase was also seen in the left ventricular ejection fraction by liothyronine as compared with the placebo (<0.001).ConclusionTriiodothyronine replacement by chronic liothyronine therapy seems to safely benefit stable HF patients with LT3S receiving optimal HF medications.

Propose: Our aim was to determine which criterion-hyperglycemia or high levels of glycosylated hemoglobin (HbA1C) is more associated with increased mortality and morbidity after coronary artery bypass graft (CABG). Methods: Two hundred and sixteen patients who underwent elective CABG were enrolled in this prospective study. In order to compare postoperative outcomes regarding HbA1c and fasting blood sugar (FBS) levels, the patients were divided into two groups based on plasma HbA1c levels >7% or ≤7% and FBS >126 mg/dl or ≤126 mg/dl. Results: Of 216 studied patients, 165 and 51 cases had levels of HbA1C ≤7% and HbA1c

The aim of the present study was to investigate whether vitamin D supplementation could improve biochemical findings and functional capacity of patients with heart failure (HF). One hundred patients with New York Heart Association (NYHA) class I through III HF were included in this prospective study and their 25-hydroxyvitamin D levels were evaluated. Only 6% of the participants had a sufficient serum concentration of 25(OH) D >30 nmol/L. Patients with insufficient or deficient serum levels of 25(OH) D (<30 ng/mL and <20 ng/mL, respectively) received oral vitamin D3 (cholecalciferol) for a total period of 4 months. Vitamin D supplementation increased mean serum concentration of 25(OH) D from 12.63±7.60 nmol/L to 54.49±18.01 nmol/L (P<.001). After vitamin D supplementation, the serum level of pro-brain natriuretic peptide markedly decreased (P<.001). Cholecalciferol significantly decreased high-sensitivity C-reactive protein level (P<.001). Restoration of serum 25(OH) D level was also associated with substantial improvement in NYHA class (P<.001) and 6-minute walk distance (P<.001).