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Changes in levels of thyroid hormones and TSH in acute myocardial infarction
Insights
Thyroid hormone levels, including thyroxine (T4) and triiodothyronine (T3), change during acute myocardial infarction (AMI). The effective thyroxine ratio (ETR) is a key indicator, especially in predicting outcomes.
Area of Science:
- Endocrinology
- Cardiology
- Internal Medicine
Background:
- Thyroid hormone levels can be altered in patients with acute myocardial infarction (AMI).
- Understanding these changes is crucial for patient management and prognosis.
Purpose of the Study:
- To investigate the dynamic changes in thyroid hormone levels (T4, T3, ETR, TSH) in patients with AMI.
- To evaluate the utility of these parameters in predicting outcomes in AMI patients.
Main Methods:
- Prospective study involving 88 patients with acute myocardial infarction.
- Serial measurements of total serum thyroxine (T4), total serum triiodothyronine (T3), effective thyroxine ratio (ETR), and serum thyroid-stimulating hormone (TSH).
Main Results:
- T4 and T3 levels decreased significantly by day 3, returning to baseline by day 7.
- ETR values were significantly reduced on days 3 and 7.
- In non-survivors (died within 96 hours), ETR was elevated on admission, and low T3 was most frequent.
- ETR demonstrated the lowest percentage of abnormal values, making it a reliable thyroid function parameter.
Conclusions:
- Thyroid hormone levels exhibit significant alterations following acute myocardial infarction.
- Effective thyroxine ratio (ETR) is a sensitive marker for thyroid function changes in AMI and may have prognostic value.
- Early detection of abnormal ETR may aid in identifying high-risk AMI patients.
Abstract:
The changes in levels of total serum thyroxine (T4), total serum triiodothyronine (T3), effective thyroxine ratio (ETR), and serum TSH were investigated in 88 patients with acute myocardial infarction (AMI). The T4 and T3 values decreased significantly on the third day of hospitalization to return to starting values on the 7th day. ETR values were significantly reduced on the 3rd day and remained so also on the 7th day. Compared to starting values, serum TSH levels were increased on the 7th day of hospitalization, yet not significantly. In the group of 16 patients who died within 96 hours, ETR values were significantly increased on the 1st day of hospitalization (immediately after admission) in comparison with the group of AMI surviving patients. The highest frequency rate of abnormally low T3 values was found in patients who died within 96 hours. With respect to thyroid function evaluation, ETR proved to be the most satisfactory parameter with the lowest percentage of abnormal values.