Predictive Value of Free Triiodothyronine to Free Thyroxine Ratio in Euthyroid Patients With Myocardial Infarction With Nonobstructive Coronary Arteries

Gao, Side; Wahab, MA; Huang, Sizhuang; Lin, Xuze; Yu, Mengyue

doi:10.3389/fendo.2021.708216

Cited by 13 publications

(17 citation statements)

References 46 publications

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“…Regarding fT4, higher levels (cut-off 12.54 pg/mL) were associated with worse outcome compared to lower levels [ 67 ]. The fT3/fT4 ratio was also shown to be associated with worse outcomes in patients diagnosed with MI with nonobstructive coronary arteries ( n = 1162) over a median follow-up of 41.7 months [ 68 ]. Patients were divided into three groups based on fT3/fT4 tertiles: tertile 1 ≥ 2.64 ( n = 387), tertile 2 2.28–2.63 ( n = 386), and tertile 3 < 2.28 ( n = 389).…”

Section: Resultsmentioning

confidence: 99%

“…Patients were divided into three groups based on fT3/fT4 tertiles: tertile 1 ≥ 2.64 ( n = 387), tertile 2 2.28–2.63 ( n = 386), and tertile 3 < 2.28 ( n = 389). Patients with lower fT3/fT4 had a higher incidence of MACE (all-cause death, nonfatal MI, revascularization, nonfatal stroke, and hospitalization for unstable angina or HF) (10%, 13.9%, and 18.2%; p = 0.005) and composite endpoint of death, reinfarction, revascularization, or stroke (5.4%, 8.5%, and 11.5%; p = 0.035) [ 68 ]. Compared to higher fT3/fT4 (tertile 1), lower fT3/fT4 was associated with an increased risk of MACE.…”

Section: Resultsmentioning

confidence: 99%

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Emerging Biomarkers for Predicting Clinical Outcomes in Patients with Heart Disease

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Lupu

et al. 2023

Life

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Cardiovascular disease is most frequently caused by the development and progression of atherosclerosis. When coronary arteries are afflicted, and the stenoses caused by atherosclerotic plaques are severe enough, the metabolic supply-and-offer balance is disturbed, leading to myocardial ischemia. If atherosclerotic plaques become unstable and local thrombosis develops, a myocardial infarction occurs. Sometimes, myocardial ischemia and infarction may result in significant and irreversible heart failure. To prevent severe complications, such as acute coronary syndromes and ischemia-related heart failure, extensive efforts have been made for developing biomarkers that would help identify patients at increased risk for cardiovascular events. In this two-part study, we attempted to provide a review of existing knowledge of blood biomarkers that may be used in this setting. The first part of this work was dedicated to conventional biomarkers, which are already used in clinical practice. In the second part, here presented, we discuss emerging biomarkers which have not yet become mainstream.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Emerging Biomarkers for Predicting Clinical Outcomes in Patients with Heart Disease

Pál

Bărcuțean

Lupu

et al. 2023

Life

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“…et al. found that a lower level of FT3/fT4 ratio remained a robust predictor of MACE in euthyroid MINOCA patients ( 29 ). When we focus on non-cardiac disease studies, high levels of FT4/FT4 ratio still represent the worsening illness condition.…”

Section: Discussionmentioning

confidence: 99%

FT4/FT3 ratio: A novel biomarker predicts coronary microvascular dysfunction (CMD) in euthyroid INOCA patients

et al. 2022

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BackgroundIschemia and no obstructive coronary artery disease (INOCA) patients who presented coronary microvascular dysfunction (CMD) demonstrate a poor prognosis, yet the risk factors for CMD remain unclear. Subtle changes in thyroid hormone levels within the normal range, especially the free thyroxine (FT4)/free triiodothyronine (FT3) ratio, have been shown to regulate the cardiovascular system. This prospective study investigated the correlation between FT4/FT3 ratio and CMD in euthyroid patients with INOCA.MethodsThis prospective study (www.chictr.org.cn/, ChiCTR2000037112) recruited patients with myocardial ischemia symptoms who underwent both coronary angiography (CAG) and myocardial perfusion imaging (MPI) with dynamic single-photon emission computed tomography (D-SPECT). INOCA was defined as coronary stenosis< 50% and CMD was defined as coronary flow reserve (CFR)<2.5. All patients were excluded from abnormal thyroid function and thyroid disease history.ResultsAmong 71 INOCA patients (15 [21.1%] CMD), FT4 and FT4/FT3 ratio in CMD group were significantly higher and both showed significantly moderate correlation with CFR (r=-0.25, p=0.03; r=-0.34, p=0.003, respectively). The ROC curve revealed that FT4/FT3 ratio had the highest efficacy for predicting CMD with an optimized cutoff value>3.39 (AUC 0.78, p<0.001, sensitivity, 80.0%; specificity, 71.4%). Multivariate logistic regression showed that FT4/FT3 ratio was an independent predictor of CMD (OR 7.62, 95% CI 1.12-51.89, p=0.038, P for trend=0.006).ConclusionIn euthyroid INOCA patients, increased FT4/FT3 ratio levels are associated with the occurrence of CMD, presenting a novel biomarker for improving the risk stratification.

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“…FT3/FT4 reaction 5’-deiodinase activity can be used to evaluate peripheral thyroid sensitivity ( 2 , 11 – 14 ). The FT3/FT4 ratio seems to be a precise and reasonable indicator of thyroid hormone metabolic change that is associated with the prognosis of specific diseases, including coronary heart disease (CHD), myocardial infarction (MI), and dilated cardiomyopathy (DCM) ( 15 – 18 ). However, there are no data on the value of the FT3/FT4 ratio in predicting mortality risk in the general population, especially in those with normal thyroid function.…”

Section: Introductionmentioning

confidence: 99%

FT3/FT4 ratio is correlated with all-cause mortality, cardiovascular mortality, and cardiovascular disease risk: NHANES 2007-2012

Lang

Zhang

et al. 2022

Front. Endocrinol.

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BackgroundThyroid hormones play a vital role in maintaining the homeostasis of the cardiovascular system. The FT3/FT4 ratio can be used to evaluate the rate of T4-to-T3 conversion, reflecting the peripheral sensitivity of thyroid hormones. There is no study to investigate its relationship with death and cardiovascular disease (CVD) in the general population.MethodsThis retrospective cohort study involved 8,018 participants with measured thyroid function and no prior thyroid disease who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012. Mortality status was determined by routine follow-up using the National Death Index through December 31, 2015.ResultsDuring a median of 87 months of follow-up, we observed 699 all-cause deaths, including 116 cardiovascular deaths. In multivariate adjusted models, higher free thyroxine (FT4) was linked to increased all-cause mortality (HR, 1.15 per SD; 95% CI, 1.09-1.22), cardiovascular mortality (HR, 1.18 per SD; 95% CI, 1.01-1.39), and CVD risk (HR, 1.17 per SD; 95% CI, 1.08-1.27). Higher free triiodothyronine (FT3) was linked to decreased all-cause mortality (HR 0.81 per SD; 95% CI, 0.70-0.93). Higher FT3/FT4 ratio was linked to decreased all-cause mortality (HR, 0.77 per SD; 95% CI, 0.69-0.85), cardiovascular mortality (HR, 0.79 per SD; 95% CI, 0.62-1.00), and CVD risk (HR, 0.82 per SD; 95% CI, 0.74-0.92). The FT3/FT4 ratio stratified findings were broadly consistent with the overall results.ConclusionsFT3, FT4, and the FT3/FT4 ratio were all independent predictors of all-cause death. FT4 and the FT3/FT4 ratio, but not FT3, were independent predictors of cardiovascular mortality and CVD risk. Along with FT3 and FT4, we should pay equal attention to the FT3/FT4 ratio in the general population.

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Predictive Value of Free Triiodothyronine to Free Thyroxine Ratio in Euthyroid Patients With Myocardial Infarction With Nonobstructive Coronary Arteries

Cited by 13 publications

References 46 publications

Emerging Biomarkers for Predicting Clinical Outcomes in Patients with Heart Disease

Emerging Biomarkers for Predicting Clinical Outcomes in Patients with Heart Disease

FT4/FT3 ratio: A novel biomarker predicts coronary microvascular dysfunction (CMD) in euthyroid INOCA patients

FT3/FT4 ratio is correlated with all-cause mortality, cardiovascular mortality, and cardiovascular disease risk: NHANES 2007-2012

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