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

Abstract

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.

Low T3 syndrome improves risk prediction of in-hospital cardiovascular death in patients with acute myocardial infarction

“…The prevalence of LT3S among patients with AMI is 23.3% in this study, which has been reported to be 5-35% in the literature [1,15,16]. The wide range could be attributed to different patient populations.…”

Thyroid stimulating hormone elevation as a predictor of long‐term mortality in patients with acute myocardial infarction

“…Alteration of thyroid function may adversely affect the heart and cardiovascular system, which has a direct effect on the cardiovascular disease and is caused by a complex relationship with risk factors for the cardiovascular disease . Hyperthyroidism is associated with systolic hypertension, atrial fibrillation, and hypercoagulability, while hypothyroidism can lead to hyperlipidemia and vascular inflammation …”

Free triiodothyronine and global registry of acute coronary events risk score on predicting long-term major adverse cardiac events in STEMI patients undergoing primary PCI

“…The prognosis of acute coronary heart disease is affected by many factors [ 1 ]. Among all neuroendocrine systems, thyroid hormone plays a major homeostatic role in modulating heart rate, cardiac contractility, and arterial peripheral resistance [ 2 , 3 ]. Accumulating evidences show that abnormal thyroid homeostasis is generally associated with increased cardiovascular morbidity and mortality in patients with coronary artery disease (CAD), heart failure, stroke and so on [ 4 – 9 ].…”