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[Subclinical hypothyroidism in patients with ischemic heart disease]
Insights
Subclinical hypothyroidism, specifically T3-low syndrome, is prevalent in coronary heart disease (CHD) patients. Treatment with triiodothyronine is recommended over thyroxine for these patients.
Area of Science:
- Endocrinology
- Cardiology
- Metabolic Disorders
Background:
- Coronary heart disease (CHD) affects a significant portion of the population.
- Thyroid dysfunction, particularly hypothyroidism, can impact cardiovascular health.
- Subclinical hypothyroidism is increasingly recognized as a potential comorbidity in CHD.
Purpose of the Study:
- To investigate the prevalence of subclinical hypothyroidism in patients with coronary heart disease.
- To characterize the specific thyroid hormone profile in CHD patients with hypothyroidism.
- To evaluate the impact of hypothyroidism on CHD progression and therapeutic implications.
Main Methods:
- Study population comprised 187 patients diagnosed with coronary heart disease.
- Assessment included serum thyroid hormone levels (T3, T4, TTG) and clinical evaluation.
- Analysis focused on identifying correlations between thyroid status and CHD characteristics.
Main Results:
- 60% of CHD patients exhibited subclinical hypothyroidism.
- A 'T3-low syndrome' was identified, characterized by low T3, normal/increased T4, and normal TTG, especially in arrhythmic CHD.
- Hypothyroidism was associated with decreased tissue oxygen consumption, increased myocardial infarction, heart failure, and advanced atherosclerosis.
Conclusions:
- Subclinical hypothyroidism, particularly the T3-low syndrome, is common in CHD patients.
- Cordarone therapy may exacerbate T3-hypothyroidism; thyroid-inhibiting drugs should be avoided.
- Triiodothyronine (T3) supplementation is recommended for T3-hypothyroidism in CHD; thyroxine (T4) is ineffective due to impaired conversion.
Abstract:
A total of 187 patients with coronary heart disease (CHD) were examined. Out of them 60% were found as having subclinical hypothyroidism. The serum levels of T3 were significantly lower, particularly in arrhythmic CHD, the level of T4 was normal and even increased, thus making the concentrations of TTG normal, i.e. the T3-low-syndrome was detected. Hypothyroidism in CHD patients decreased tissue oxygen consumption, by reducing the incidence of acute myocardial infarction, heart failure, the atherosclerotic process becoming disseminated and progressive. Cordarone therapy was found to promote the progression of T3-hypothyroidism, i.e. in CHD patients with suspected hypothyroidism, the drugs inhibiting the thyroidal function should not be used. T3-Hypothyroidism should be corrected with adequate doses of triiodothyronine in CHD patients. The use of thyroxine is ineffective as the conversion of T4 to T3 is impaired in the body.