Sick euthyroid syndrome is associated with poor prognosis in patients with ST segment elevation myocardial infarction undergoing primary percutaneous intervention

Özcan, Kazım Serhan; Osmonov, Damirbek; Toprak, Ercan; Güngör, Barış; Tatlısu, Adem; Ekmekçi, Ahmet; Kaya, Adnan; Tayyareci, Gülşah; Erdinler, İzzet

doi:10.5603/cj.a2013.0108

Cited by 46 publications

(45 citation statements)

References 21 publications

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“…However, the association between TSH level and mortality persisted after adjustment for cardiogenic shock. An increase in the incidence of cardiogenic shock in patients with acute myocardial infarction and euthyroid sick syndrome -a state of adaptation where the levels of thyroid hormones are low but thyroid gland is not dysfunctional -has been reported [34]. Third, we did not find an association between TSH in the upper part of reference range and thrombotic complications (myocardial infarction, stent thrombosis or stroke) which are well-known correlates of early and late mortality after PCI.…”

Section: Discussionmentioning

confidence: 48%

Prognostic value of thyroid-stimulating hormone within reference range in patients with coronary artery disease

Ndrepepa¹,

Braun²,

Mayer³

et al. 2015

Metabolism

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Section: Discussionmentioning

confidence: 48%

Prognostic value of thyroid-stimulating hormone within reference range in patients with coronary artery disease

Ndrepepa¹,

Braun²,

Mayer³

et al. 2015

Metabolism

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“…In line with these results are the conclusions of another small‐sized study by Pimentel et al, who found an association of abnormal THs alterations with worse prognosis . Two further larger studies involving consecutive STEMI patients undergoing primary percutaneous coronary intervention also have related the low T3 syndrome to increased short‐ and long‐term mortality . Moreover, a recent study with patients attending a cardiac rehabilitation program after an ACS also has reported an association of lower fT3 levels with all‐cause mortality …”

Section: Prognostic Value Of Thyroid Hormones In Acsmentioning

confidence: 94%

“…The exact prevalence of the low T3 syndrome among patients suffering an ACS seems not to be clearly defined yet. A wide range from 5% to 35% has been reported in literature, and this could be attributed to differences in study populations between the conducted studies . However, the syndrome seems to occur more frequently in STEMI compared with NSTEMI patients, possibly because of their poorer early prognosis and the pathophysiologic features of the occlusive thrombus resulting in more myocardium at stake …”

Section: Thyroid Hormonal Alterations During Acsmentioning

confidence: 97%

“…Normal thyroid homeostasis seems to alter in a subgroup of patients with ACS. Several studies have observed a fall in total T3 and/or fT3 concentration and rise in rT3 concentration after an acute coronary event . The exact prevalence of the low T3 syndrome among patients suffering an ACS seems not to be clearly defined yet.…”

Section: Thyroid Hormonal Alterations During Acsmentioning

confidence: 99%

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The role of thyroid hormones in acute coronary syndromes: Prognostic value of alterations in thyroid hormones

Lamprou

Varvarousis

Polytarchou

et al. 2017

Clinical Cardiology

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The prognosis of acute coronary syndromes (ACS) is affected by many factors. Normal thyroid homeostasis is known to alter during various critical illnesses, a condition that has been shown to correlate with the severity of the disease and increased mortality. The purpose of this article is to review literature to emphasize the considerable association of thyroid function with the cardiovascular system and summarize all existing evidence with regard to the role of thyroid hormones alterations during ACS. The electronic databases of PubMed, Medline, Scopus, and Cochrane were searched for relevant literature and studies. Alterations in thyroid hormone plasma concentrations, especially low triiodothyronine (T3) levels, represent a hormonal imbalance that is not uncommon among patients suffering an acute coronary event. Many studies have identified this abnormal thyroid hormonal status to be related to worse prognosis. Although further large‐scale clinical trials are needed, the low T3 syndrome manifesting in patients during ACS might be useful in prognostic stratification.

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“…Recently, Ozcan et al [36] showed that this syndrome was linked to both in-hospital and long-term mortality in STEMI patients undergoing primary PCI. Although we did not choose mortality as a primary endpoint, our results appear to differ from those of previous studies.…”

Section: Discussionmentioning

confidence: 99%

Prediction of infarct severity from triiodothyronine levels in patients with ST-elevation myocardial infarction

Kim

Choi

Kim

et al. 2014

Korean J Intern Med

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Background/AimsThe aim of the present study was to evaluate the relationship between thyroid hormone levels and infarct severity in patients with ST-elevation myocardial infarction (STEMI).Methods We retrospectively reviewed thyroid hormone levels, infarct severity, and the extent of transmurality in 40 STEMI patients evaluated via contrast-enhanced cardiac magnetic resonance imaging.ResultsThe high triiodothyronine (T3) group (≥ 68.3 ng/dL) exhibited a significantly higher extent of transmural involvement (late transmural enhancement > 75% after administration of gadolinium contrast agent) than did the low T3 group (60% vs. 15%; p = 0.003). However, no significant difference was evident between the high- and low-thyroid-stimulating hormone/free thyroxine (FT4) groups. When the T3 cutoff level was set to 68.3 ng/dL using a receiver operating characteristic curve, the sensitivity was 80% and the specificity 68% in terms of differentiating between those with and without transmural involvement. Upon logistic regression analysis, high T3 level was an independent predictor of transmural involvement after adjustment for the presence of diabetes mellitus (DM) and the use of glycoprotein IIb/IIIa inhibitors (odds ratio, 40.62; 95% confidence interval, 3.29 to 502; p = 0.004).ConclusionsThe T3 level predicted transmural involvement that was independent of glycoprotein IIb/IIIa inhibitor use and DM positivity.

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Sick euthyroid syndrome is associated with poor prognosis in patients with ST segment elevation myocardial infarction undergoing primary percutaneous intervention

Cited by 46 publications

References 21 publications

Prognostic value of thyroid-stimulating hormone within reference range in patients with coronary artery disease

Prognostic value of thyroid-stimulating hormone within reference range in patients with coronary artery disease

The role of thyroid hormones in acute coronary syndromes: Prognostic value of alterations in thyroid hormones

Prediction of infarct severity from triiodothyronine levels in patients with ST-elevation myocardial infarction

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