Thyroid hormone profile in acute coronary syndromes
Rodrigo Caetano Pimentel1, Gilberto Perez Cardoso, Claudia Caminha Escosteguy
1Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil. rodrigocp@cardiol.br
Arquivos Brasileiros De Cardiologia
|January 31, 2007
Summary
Euthyroid sick syndrome, characterized by altered thyroid hormones, is linked to poorer prognosis in acute coronary syndrome (ACS) patients, especially those with ST-segment elevation myocardial infarction (STEMI). Recognizing this hormonal imbalance is crucial for patient outcomes.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Acute coronary syndromes (ACS) represent a spectrum of clinical presentations including unstable angina and myocardial infarction.
- Thyroid hormone levels can be altered in critically ill patients, a condition known as euthyroid sick syndrome (ESS).
Purpose of the Study:
- To investigate thyroid hormone profiles in patients with ACS, differentiating between unstable angina/non-ST-segment elevation myocardial infarction (UA/NSTEMI) and ST-segment elevation myocardial infarction (STEMI).
- To correlate thyroid hormone patterns with patient outcomes, including mortality.
Main Methods:
- Prospective study of 70 ACS patients admitted to a coronary care unit.
- Blood samples collected on days 1, 4, and 7 post-admission for thyroid hormone analysis (T3, free T3, reverse T3, TSH, T4, free T4).
- Clinical evaluation and electrocardiograms performed during hospitalization.
Main Results:
- 18.6% of ACS patients exhibited ESS (decreased T3/free T3, increased reverse T3, normal TSH/T4/free T4).
- STEMI patients showed elevated reverse T3 and lower T3/free T3 levels compared to UA/NSTEMI.
- Patients who died had hormonal profiles consistent with ESS, with more pronounced reverse T3 and T3 alterations.
Conclusions:
- Euthyroid sick syndrome is relevant in ACS patients.
- ESS is associated with a poorer prognosis in acute coronary syndrome.
- Recognizing ESS is important for managing coronary heart disease patients.
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