Association of Thyroid Function with Severity of Coronary Artery Disease in Euthyroid Patients

Daswani, Ravi

doi:10.7860/jcdr/2015/10908.6059

Cited by 14 publications

(16 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study revealed a decreased length of survival in AMI patients with first quartile of fT3, confirming previous findings. Additionally, we estimate that fT3 levels within the normal concentration ranges was probably due to omitted analysis of TH during the later post-AMI period when greater fT3 downregulations could be observed The present study lends support to the theory advanced by other research teams that fT3 represents the biologically active form of TH, so an isolated reduction in its level could constitute a model of abnormal TH metabolism acting as a risk factor for CAD 3,[27][28][29] . Further, subclinical hypothyroidism, characterized by normal serum concentrations of fT4 and elevated TSH showed as a predictor of atherosclerosis and MI risk in elderly women 3,27,77,78 .…”

Section: Discussionsupporting

confidence: 84%

“…However, Ertas et al 28 showed that within the normal range fT3 levels were inversely associated with CAD severity. It was also found that lower fT3 concentrations independently predicted the severity of CAD 29 . Mayer et al, showed that even minor changes of fT4 may relate with severity of HF 30,31 .…”

Section: Discussionmentioning

confidence: 90%

“…Further, subclinical hypothyroidism, characterized by normal serum concentrations of fT4 and elevated TSH showed as a predictor of atherosclerosis and MI risk in elderly women 3,27,77,78 . It is suggested that even within the clinically normal range variations of TH indicate abnormal TH metabolism associated with coronary disease risk and outcomes 24,[27][28][29][30]79 . However, Ertas et al 28 showed that within the normal range fT3 levels were inversely associated with CAD severity.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

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 .

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

show abstract

“…Coronary artery disease (CAD) prevalence and mortality were reported to be higher in subclinical hypothyroidism . Free T3 levels and CAD have been shown to be related even in the absence of thyroid dysfunction . CAD was found to be more frequent and severe in low T3 levels .…”

Section: Discussionmentioning

confidence: 99%

Relation of Low T3 to One-Year Mortality in Non-ST-Elevation Acute Coronary Syndrome Patients

Yazıcı

Kırış

Ceylan

et al. 2016

J. Clin. Lab. Anal.

View full text Add to dashboard Cite

show abstract

“…Daswani and cols. found lower FT3 levels in patients with three stenosed vessels were more affected in CAD than in normal patients (38). Finally, the possibility that serum TSH levels is a cardiovascular risk factor has been a subject of debate, and a broad studies are needed for answer this point.…”

Section: Discussionmentioning

confidence: 97%

Association of serum thyrotropin levels with coronary artery disease documented by quantitative coronary angiography: a transversal study

P¹,

Romaldini²,

Guerra³

et al. 2018

Archives of Endocrinology and Metabolism

View full text Add to dashboard Cite

Objective: The association between coronary artery disease (CAD) and thyroid function remains controversial. We evaluated the thyroid function and graduated well-defined CAD as confirmed by quantitative coronary angiography (CA). Subjects and methods: We evaluated the serum TSH, free thyroxine, free triiodothyronine and thyroid antibody levels in 300 consecutive patients (age 61.6 ± 9.9 years and 54% were male) undergoing CAD diagnosis as confirmed by CA. Plaques with ≥ 50% stenosis being indicative of obstructive CAD, and patients were divided into groups according to main epicardial coronary arteries with plaques (0, 1, 2, 3). Lipid profiles and a homeostasis model assessment (HOMA-IR) were determined. Results: Serum median (25% and 75% percentile) TSH levels in patients with group 2 and 3 (2.25; 1.66-3.12 mU/L and 4.99; 4.38-23.60 mU/L, respectively) had significantly higher TSH concentrations (p < 0.0001) than the group 0 (1.82; 1.35-2.51 mU/L). Furthermore, patients of group 3 had higher TSH concentration (p < 0.0001) than those of group 1 (1.60; 0.89-2.68 mU/L). Group 3 were older (64 ± 8.5 vs. 59 ± 9.5, p = 0.001), had more patients with dyslipidemia (84% versus 58%, p < 0.001), male (54% versus 44%, p = 0.01), hypertension (100% versus 86%, p < 0.001), and smoking (61% versus 33%, p < 0.001) than group 0. Multivariate stepwise logistic analysis showed TSH, age, HbA1c, and HOMA-IR were the CAD associated variables. Conclusions: In this cohort, elevated TSH levels in the high normal range or above are associated with the presence and severity of CAD besides may represent a weak CAD risk factor.

show abstract

Association of Thyroid Function with Severity of Coronary Artery Disease in Euthyroid Patients

Cited by 14 publications

References 17 publications

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

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

Relation of Low T3 to One-Year Mortality in Non-ST-Elevation Acute Coronary Syndrome Patients

Association of serum thyrotropin levels with coronary artery disease documented by quantitative coronary angiography: a transversal study

Contact Info

Product

Resources

About