Levels of thyroid hormone, ferritin and testosterone in Acute Myocardial Infarction (AMI) patients in north India

Abstract

Background : Thyroid hormone plays a critical role in cardiomyocyte maturation and stress-related cellular responses like AMI. The inhibition of thyroid hormone receptor alfa (TRα) causes down regulation of this hormone in post-ischemic myocardium. On the other hand, ferritin, an inflammatory marker; and testosterone, a hormone which alters lipid profile, also play significant roles in pathogenesis of AMI. The objective of our study was to compare thyroid profile (total T3, T4 and TSH), ferritin, Vitamin B-12, folic acid and testosterone in newly diagnosed male cases of AMI with age-matched controls. We also contrasted these biochemical parameters between AMI subgroups with very low and low left ventricular ejection fraction (LVEF). Methodology :A cross-sectional study was conducted from September, 2012 to February, 2013 at a tertiary care hospital of north India. Newly diagnosed male AMI patients with positive clinical and ECG findings, and CPK MB > 25 U/L (spcetrophotometric method) and Troponin-I ultra > 2ng/ml (chemiimmunofluroscence method) were enrolled as cases (n=43). Cases were further sub-classified into those with very low LVEF (<35%, Group 1) and low LVEF (35-50%, Group 2). Serum was pooled at 12-24 hr of onset of symptoms and preserved at-20°C until analyzed. Serum TSH was measured with immunoradiometric assay; serum T3 and T4 were measured with radioimmuno assay. Serum ferritin, Vitamin B-12, folic acid and testosterone were also estimated (chemiimmunofluroscence method) in all cases. 40 age and sex matched controls were similarly examined. Result :AMI patients reported significantly lower T3, higher ferritin and lower testosterone level in comparison to control group. On the other hand, cases with lower LVEF (<35%) showed significantly lower value of CPK MB, T3, ferritin and testosterone. Conclusion :Our study found down regulation of T3 and testosterone levels, with raised higher ferritin levels in patients suffering from an acute attack of AMI.

The Prognostic Performance of Ferritin in Patients with Acute Myocardial Infarction: A Systematic Review

“…All investigated studies had a non-randomized observational design [ 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Two studies investigated patients prospectively [ 16 , 18 ], while the cross-sectional design was reported in the other two studies [ 19 , 21 ].…”

“…All investigated studies had a non-randomized observational design [ 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Two studies investigated patients prospectively [ 16 , 18 ], while the cross-sectional design was reported in the other two studies [ 19 , 21 ]. Most of the studies analysed in-hospital adverse events [ 16 , 20 , 21 ], but the follow-up period varied across studies ranging from 30 days up to 6 months [ 15 , 18 ].…”

“…Most of the studies analysed in-hospital adverse events [ 16 , 20 , 21 ], but the follow-up period varied across studies ranging from 30 days up to 6 months [ 15 , 18 ]. Four studies enrolled patients with STEMI [ 15 , 16 , 18 , 21 ], while the rest included patients presenting with all types of AMI [ 17 , 19 , 20 ].…”

“…Clinical studies also documented an association between ferritin levels and LVEF [ 18 , 19 , 20 ]. Suzuki et al enrolled patients with STEMI and successful PCI and measured LVEF at baseline and 6-month follow-up [ 18 ].…”

“…In a cross-sectional study, Basu et al recorded significantly higher ferritin values in patients with LVEF < 35% than in those with LVEF ranging between 35% and 50% ( p = 0.002) [ 19 ]. However, the investigators enrolled only male patients, thus limiting the generalization of the results in all patients.…”