Association between reverse triiodothyronine and cardiac complications in patients with uncontrolled Graves' disease

Area of Science:

• Endocrinology
• Cardiology
• Internal Medicine

Background:

• Graves' disease often leads to cardiac complications in hyperthyroid patients.
• The correlation between thyrotoxicosis severity and cardiac issues needs further confirmation.
• This study focuses on reverse triiodothyronine (rT3) as a potential indicator.

Purpose of the Study:

• To investigate the association between serum rT3 levels and cardiac complications.
• To determine if rT3 can serve as a biomarker for thyrotoxicosis severity and related cardiac issues.
• To analyze cardiac outcomes in hospitalized patients with uncontrolled Graves' disease.

Main Methods:

• A cross-sectional study of 178 hospitalized patients with uncontrolled Graves' disease (2016-2020).
• Identified atrial fibrillation and heart failure as direct outcomes of thyrotoxicosis.
• Utilized multivariate logistic regression and restricted cubic splines to analyze the relationship between serum rT3 and cardiac complications.

Main Results:

• Over half (54.0%) of patients experienced cardiac complications.
• A linear dose-response relationship was observed between serum rT3 and cardiac complications.
• Each 1 nmol/L increase in rT3 correlated with a 65% increased odds of cardiac complications (OR 1.65).

Conclusions:

• Elevated serum rT3 is a strong predictor of atrial fibrillation and heart failure in uncontrolled Graves' disease.
• rT3 levels are associated with increased hyperthyroidism severity and cardiac complications.
• rT3 serves as a valuable biomarker for assessing cardiac risk in these patients.