Is Low-free Triiodothyronine (fT3) Associated with Increased Morbidity in Patients Admitted to Coronary Care Units?

Oğuz Akkuş, Fatih Şen, Ramazan Yasdıbaş, Alper Tunga Ötegen, İrem Hüzmeli, Gamze Akkuş
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Abstract

Background: The effects of thyroid hormone on patients hospitalized in coronary intensive care units are still controversial.

Objective: We retrospectively examined thyroid hormone levels and their impact on cardiovascular morbidity in patients admitted to coronary intensive care units.

Methods: A total of 208 (Female/Male; 46.6%/53.4%) patients without any history of thyroid disease were enrolled and screened. Patients with specific heart disease and existing thyroid hormone parameters were included in the study. Low triiodothyronine syndrome is characterized by reduced serum total or free T3 (fT3) concentrations in normal free T4 (fT4) and TSH levels.

Results: The common diagnosis of the patients in the coronary care unit is acute coronary syndrome (n=59, 28.2 %) and heart failure (n=46, 23.3%). Patients were divided into two groups according to left ventricular ejection fraction percentages (LVEF ≤39% vs LVEF ≥40%). Plasma fT3 levels were significantly correlated with low LVEF (≤39%) (p =0.002). fT3 (r=-0.183, p =0.013) and hospitalization etiology (r=-0.161, p =0.023) were also the most critical parameters affecting the length of hospitalization.

Conclusion: Low fT3 was associated with reduced ejection fraction and prolonged hospitalization, which may lead to potential morbidities in HF patients and may be useful in risk stratification and treatment strategies.

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低游离三碘甲状腺原氨酸 (fT3) 是否与冠心病监护病房住院患者发病率增加有关?
背景:甲状腺激素对冠心病重症监护病房住院患者的影响仍存在争议。我们对冠心病重症监护病房住院患者的甲状腺激素水平及其对心血管疾病发病率的影响进行了回顾性研究:共招募并筛查了 208 名(女性/男性;47.1%/52.9%)无甲状腺疾病史的患者。研究还纳入了患有特殊心脏病且现有甲状腺激素参数的患者。低三碘甲状腺原氨酸综合征的特征是血清总T3或游离T3(fT3)浓度降低,而游离T4(fT4)和促甲状腺激素(TSH)水平正常:冠心病监护室患者的常见诊断是急性冠状动脉综合征(59人,占28.2%)和心力衰竭(46人,占23.3%)。根据左心室射血分数百分比将患者分为两组(LVEF ≤39% vs LVEF ≥40%)。血浆fT3水平与低LVEF(≤39%)显著相关(p =0.002)。fT3(r=-0.183,p =0.013)和住院病因(r=-0.161,p =0.023)也是影响住院时间的最关键参数:低fT3与射血分数降低和住院时间延长有关,这可能导致心房颤动患者的潜在发病率,这可能有助于风险分层和治疗策略。
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