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Euthyroid sick syndrome in acute ischemic syndromes
H N Pavlou1, P A Kliridis, A A Panagiotopoulos
1Second Department of Cardiology, St Andreas Patras State Hospital, University of Patras Medical School, Greece. chuck@otenet.gr
Angiology
|December 5, 2002
Summary
Euthyroid sick syndrome occurs in acute myocardial infarction and unstable angina, characterized by decreased T3 and increased rT3 levels. These thyroid hormone changes are linked to cardiac damage severity and are not influenced by beta-blocker or thrombolytic therapies.
Area of Science:
- Endocrinology
- Cardiology
- Internal Medicine
Background:
- Euthyroid sick syndrome (ESS) is a condition where thyroid hormone levels change in non-thyroidal illness.
- Acute myocardial infarction (AMI) and unstable angina (UA) are critical cardiovascular events that may impact thyroid function.
Purpose of the Study:
- To investigate the occurrence of ESS in patients with AMI or UA.
- To explore the relationship between ESS and beta-blocker or thrombolytic therapy.
Main Methods:
- Plasma levels of triiodothyronine (T3), reverse T3 (rT3), free T3 (FT3), thyroxine (T4), free T4 (FT4), thyroid-stimulating hormone (TSH), thyroxine-binding globulin (TBG), and albumin (ALB) were measured.
- Hormonal levels were assessed in 95 AMI and 19 UA patients over 5 days and 1 month post-admission.
- Patients were analyzed based on the presence of complicated infarctions and treatment with beta-blockers or thrombolytics.
Main Results:
- A significant decrease in T3 and increase in rT3 occurred in all patients within 5 days of admission.
- Patients with complicated infarctions showed a more pronounced T3 decrease and rT3 increase.
- Decreased TSH, T4, TBG, and ALB levels were observed only in complicated infarctions.
- No significant differences in hormonal changes were found between patients receiving beta-blocker or thrombolytic therapy versus those who did not.
Conclusions:
- Euthyroid sick syndrome (low T3) is present in both AMI and UA patients.
- The severity of thyroid hormone alterations correlates with cardiac damage severity, suggesting prognostic value.
- Beta-blocker therapy and thrombolysis do not appear to influence the occurrence or pattern of ESS in these patients.