Association between increased levels of reverse triiodothyronine and mortality after acute myocardial infarction
Association between increased levels of reverse triiodothyronine and mortality after acute myocardial infarction
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DOI：
10.1016/s0002-9343(01)00980-9
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发表时间：
2001-12-15
影响因子：
5.9
通讯作者：
Ahnve, S
中科院分区：
文献类型：
--
作者：
Friberg, L;Drvota, V;Ahnve, S
目的：甲状腺激素系统可能会在重症患者中暂时下调。这种“甲状腺功能正常病态综合征”可能是一种保存能量的适应性反应。然而，甲状腺激素对心血管系统也有有益的作用，如改善心脏功能，降低全身血管阻力，降低血清胆固醇水平。我们研究了心肌梗死时甲状腺激素水平是否与随后的死亡率相关。血清甲状腺激素水平对331例连续急性心肌梗死患者进行了三碘甲状腺原氨酸[T-3]、反相T-3、游离甲状腺素[T-4]和促甲状腺激素的测定（平均年龄[+/- SD]，68 +/- 12岁），来自入院时获得的样本。53例患者（16%）在1年内死亡，百分之十（16/165）T-3水平逆转的患者心肌梗死后第一周内，血浆中无活性代谢物浓度>0.41 nmol/L（中位数）的患者死亡，而血浆中无活性代谢物浓度低于0.41 nmol/L的患者死亡（P
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 [T-3], reverse T-3, free thyroxine [T-4], 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 T-3 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