Relation of Triiodothyronine to Subclinical Myocardial Injury in Patients With Chest Pain

Non-thyroidal illness syndrome predicts outcome in adult critically ill patients: a systematic review and meta-analysis

“…Systematic reviews evaluating patients with acute neurologic events ( 43 , 44 ), cardiovascular disease ( 14 ), sepsis ( 13 ), and chronic renal failure ( 45 , 46 ) point to an incremental risk of unfavorable outcomes in patients with NTIS. Experimental and clinical studies support the hypothesis that reduced serum and tissue concentrations of T3 may be implicated in organic dysfunction commonly related to the critically ill as diminished cognitive status with lethargy ( 47 ), altered cardiac inotropism and chronotropism, altered vasoactive properties ( 48 , 49 ), inability to control bacterial infections due to reduced response of the innate immune system ( 50 ), respiratory muscle weakness ( 51 ), reduced synthesis of pulmonary surfactant, and decrease of lung compliance resulting in the impairment of lung function ( 52 ). The significant correlation between decreased TH and organic dysfunctions indicates the possibility of the use of TH as a prognostic factor for the critically ill, as multiple organ dysfunction syndrome is the most frequent cause of death in the ICU ( 53 ).…”

Value of Low Triiodothyronine and Subclinical Myocardial Injury for Clinical Outcomes in Chest Pain

“…8 Indeed, several authors have proposed that somewhat elevated troponin values may designate subclinical cardiac injury and that high-sensitivity cTnT (hs-cTnT) may presently permit the detection of early phases of myocardial damage masked in the past. 9, 10 Kim et al 11 previously reported that T3 levels were inversely associated with hs-cTnT levels in patients with no clinically evident CHD. However, no information is available regarding the impact of a low T3 level and subclinical myocardial injury on long-term clinical outcomes.…”