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[The effect of kordaron on thyroid function in patients with ischemic heart disease]
Insights
Coronary heart disease patients with arrhythmia often have low thyroid hormone T3. Cordarone treatment for arrhythmia can worsen this T3 deficiency, leading to hypothyroidism.
Area of Science:
- Endocrinology
- Cardiology
Background:
- Coronary heart disease (CHD) patients with arrhythmia may present with thyroid dysfunction.
- Thyroid hormone levels, specifically T3 and T4, are crucial for cardiovascular health.
Purpose of the Study:
- To assess thyroid function in patients with arrhythmic CHD before and during cordarone treatment.
- To investigate the impact of cordarone on thyroid hormone levels in this patient group.
Main Methods:
- Thyroid function tests (TTH, T3, T4) were performed on 56 patients with arrhythmic CHD.
- Patients were evaluated prior to and during cordarone therapy.
Main Results:
- Initially, patients showed normal TTH and T4 but low T3, indicating a latent T3-low syndrome.
- Cordarone treatment exacerbated T3 deficiency by inhibiting T4 to T3 conversion and potentially causing thyroid damage.
- Long-term cordarone use (1-8 years) led to manifest hypothyroidism.
Conclusions:
- Arrhythmic CHD patients may have underlying T3 deficiency.
- Cordarone treatment can worsen thyroid dysfunction in these patients, leading to hypothyroidism.
- The iodine content in cordarone did not appear to trigger autoimmune thyroid disease.
Abstract:
Thyroid function has been assessed in 56 patients with arrhythmic coronary heart disease (CHD) prior to and in the course of cordaron treatment. TTH level made up initially 1.39 +/- 0.27 IU/ml which was normal. T3 blood concentration was low--1.28 +/- 0.06 nmol/l; T4 was normal--128.26 +/- 4.9 nmol/l. It is stated that CHD patients with arrhythmia develop latent hypothyrosis of T3-low-syndrome type. Arrhythmia treatment with cordaron aggravates T3 deficiency as the drug inhibits T4 conversion into T3 in peripheral tissues. It also causes toxic damage to thyroid parenchyma resulting in higher TH levels in the blood. CHD patients receiving long-term cordaron (1 to 8 years) have clinical picture of manifest hypothyrosis. Cordaron molecules includes iodine macro-doses, but these fail to initiate autoimmune thyroid process.