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Cited by 101Thyroid Disorders and TreatmentsAcute Myocardial Infarction ResearchHormonal and reproductive studies

Association between increased levels of reverse triiodothyronine and mortality after acute myocardial infarction

Friberg, Leif, Drvota, Viktor, Bjelak, Aida Hot, Eggertsen, Gösta, Ahnve, Staffan·2001·The American Journal of Medicine
DOI 10.1016/s0002-9343(01)00980-9
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Abstract

Purpose The thyroid hormone system may be downregulated temporarily in patients who are severely ill. This "euthyroid sick syndrome" may be an adaptive response to conserve energy. However, thyroid hormone also has beneficial effects on the cardiovascular system, such as improving cardiac function, reducing systemic vascular resistance, and lowering serum cholesterol levels. We investigated whether thyroid hormone levels obtained at the time of myocardial infarction are associated with subsequent mortality.Patients and methods Serum levels of thyroid hormones (triiodothyronine [T3], reverse T3, free thyroxine [T4], and thyroid-stimulating hormone) were measured in 331 consecutive patients with acute myocardial infarction (mean age [+/- SD], 68 +/- 12 years), from samples obtained at the time of admission.Results Fifty-three patients (16%) died within 1 year. Ten percent (16 of 165) of patients with reverse T3 levels (an inactive metabolite) >0.41 nmol/L (the median value) died within the first week after myocardial infarction, compared with none of the 166 patients with lower levels (P <0.0004). After 1 year, the corresponding figures were 24% (40 of 165) versus 7.8% (13 of 166; P <0.0001). Reverse T3 levels >0.41 nmol/L were associated with an increased risk of 1-year mortality (hazard ratio = 3.0; 95% confidence interval: 1.4 to 6.3; P = 0.005), independent of age, previous myocardial infarction, prior angina, heart failure, serum creatinine level, and peak serum creatine kinase-MB fraction levels.Conclusion Determination of reverse T3 levels may be a valuable and simple aid to improve identification of patients with myocardial infarction who are at high risk of subsequent mortality.

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Crossref · 10.1016/s0002-9343(01)00980-9

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  • An increase in reverse triiodothyronine is a predictor of both short- and long-term mortality independent of other traditional parameters.

    “The increase in rT 3 , the inactive TH metabolite, is a predictor of both short-and long-term mortality independent of other traditional parameters (120).”

    From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [120]

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Authors
Friberg, L., Drvota, V., Bjelak, A. H., Eggertsen, G., & Ahnve, S.
Affiliations
Karolinska Institutet (SE)
Corresponding author
Ahnve, Staffan
ORCID
Friberg, Leif
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
2001-12
Volume
111
Issue
9
Pages
699-703
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/s0002-9343(01)00980-9
OpenAlex
W2046316442
Cited by
101
References
25
Citations by year
2025: 3 · 2023: 3 · 2022: 5 · 2021: 7 · 2020: 12 · 2019: 4 · 2018: 8 · 2017: 2 · 2016: 8 · 2015: 2 · 2014: 7 · 2013: 4 · 2012: 5
FWCI
1.15
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
Karolinska Institutet
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
reverse T3, acute myocardial infarction, mortality, low T3 syndrome, thyroid hormones, triiodothyronine, free thyroxine, thyroid-stimulating hormone, cardiovascular risk stratification, prognostic factors
MeSH terms
Aged, Female, Humans, Male, Myocardial Infarction, Prognosis, Sweden, Triiodothyronine, Reverse, Biomarkers, Multivariate Analysis, Proportional Hazards Models, Survival Analysis

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