| Autor: |
Friberg, Leif, Werner, Sigbritt, Eggertsen, Gösta, Ahnve, Staffan |
| Předmět: |
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| Zdroj: |
Archives of Internal Medicine; 6/24/2002, Vol. 162 Issue 12, p1388, 7p |
| Abstrakt: |
Background: In severe illness of any cause, down-regulation of the thyroid hormone system may occur. How this affects patients with acute myocardial infarction (AMI) is largely unknown. Objective: To investigate changes in serum levels of the thyroid hormones during AMI and their association with cardiac function and outcome. Methods: Forty-seven consecutive euthyroid patients with AMI were studied prospectively during the first 5 days and again 6 and 12 weeks later. Time from pain onset was used in all analyses. Results: The thyroid hormone system was rapidly down-regulated with maximal changes 24 to 36 hours after onset of symptoms. The mean level of the hormone total triiodothyronine (T[sub 3]) decreased 19% (P = .02), the inactive metabolite reverse T[sub 3] (rT[sub 3]) levels increased 22% (P = .01), and thyrotropin levels declined 51% (P<.001) between the first 6-hour and the 24- to 36-hour period. The prohormone free thyroxine was largely unchanged. Patients with poor heart function or more intense inflammatory reaction showed more pronounced down-regulation of the thyroid system. No correlation was found with cardiac enzymes. Patients with prior angina pectoris had lower T[sub 3] levels in early samples, smaller infarctions, and higher levels of C-reactive protein and the proinflammatory cytokine interleukin 6 on admittance. Peak levels of interleukin 6 correlated negatively with T[sub 3] (P = .005) and positively with rT[sub 3] (P<.05), suggesting that down-regulation before AMI may be cardioprotective. However, mortality was high among patients with the most pronounced thyroid level depression, indicating that down-regulation after AMI may be maladaptive. Conclusions: The thyroid hormone system is rapidly down-regulated in AMI. This may be beneficial during acute ischemia. Patients with angina had higher levels of interleukin 6 and C-reactive protein and more depressed thyroid hormone system in early samples. Thyroid level depression in patients with... [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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