Thyroid Hormone Profile in Patients With Acute Coronary Syndrome

Abstract

Background:Thyroid hormone has the a major role in the cardiovascular system function and cardiac a As well as to maintain the cardiovascular homeostasis A slightly change ind thyroid status actually affects cardiovascular mortality hemodynamic. The background of this study was to define the prevalence of thyroid dysfunction in acute coronary syndrome (ACS).Objectives:The primary objective was to define the prevalence of thyroid dysfunction in acute coronary syndrome, including Non-ST Segment Elevation Myocardial Infarction (NSTEMI), ST-segment Elevation Myocardial Infarction (STEMI), and unstable angina groups. The secondary objective was to determine any associations of thyroids function tests with cardiac catheterization and mortality.Patients and Methods:In a prospective, observational, and cross section study, we enrolled 400 patients admitted at the coronary care unit of King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Venous blood samples were collected from patients for the evaluation of thyroid function (thyroids stimulating hormones, free triiodothyronine, and free thyroxin).Results:Excluding those taking thyroid hormone preparations, 76.7% of patients admitted with acute coronary heart disease (ST-segment elevation myocardial infarction and Non-ST segment elevation myocardial infarction), and unstable angina had euthyroidism. Thyroid dysfunction was reported in 23.3% of patients with coronary heart disease. Overall hypothyroidism prevalence was 7.8%, while subclinical hyperthyroidism in our study was 2.7%. Overt hyperthyroidism and subclinical hyperthyroidism was reported 2.0% and 0.5%, respectively. Euthyroid sick syndrome was noticed in 41 (10.2%) of critically ill patients. The mortality rate was 9.8%; all death patients had low triiodothyronine (T3) syndrome and were associated with statistically significant low free triiodothyronine (FT3) (P > 0.001).Conclusions:No significant variance was observed among patients underwent for cardiac catheterization, STEMI, NSTEMI, unstable angina, and atrial fibrillation with respect to FT4, FT3, and TSH levels during coronary care unit hospitalization based on their profile data.

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

“…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 …”

“…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.…”

Thyroid profile as a marker of poor prognostic factor in patients with acute coronary syndrome: a tertiary care hospital based observational study

“…5 Additionally hypothyroidism is emerging as a risk for coronary artery disease. 6 Evaluation of thyroid hormone plasma levels has been done in a number of studies in patients presenting with Acute Coronary Syndrome (ACS) and findings compared between Unstable Angina/Non-ST elevation MI (UA/NSTEMI) and ST Elevation acute MI (STEMI) groups. 1,7 Some studies have reported association of greater hormonal changes with more severe cardiac events( STEMI and Death) and patients with complications.…”

“…1,7,8 An association of Euthyroid sick syndrome in ACS with poorer prognosis has been suggested in few studies. 1,6 It has further been stated that the euthyroid sick syndrome has special significance in patients of ACS because low T3 levels in these patients signify severe disease and can be used as a marker for early invasive management in these patients. 6 Till date to my knowledge there are no data regarding thyroid profile in ACS patients from this part of world.…”

“…1,6 It has further been stated that the euthyroid sick syndrome has special significance in patients of ACS because low T3 levels in these patients signify severe disease and can be used as a marker for early invasive management in these patients. 6 Till date to my knowledge there are no data regarding thyroid profile in ACS patients from this part of world. This study aims to study the thyroid hormone profile in patients of ACS and to compare it in between STEMI and UA/NSTEMI groups.…”