Korean J Intern Med.  2014 Jul;29(4):454-465.

Prediction of infarct severity from triiodothyronine levels in patients with ST-elevation myocardial infarction

• Kim DH
• Choi DH
• Kim HW
• Choi SW
• Kim BB
• Chung JW
• Koh YY
• Chang KS
• Hong SP

Abstract

BACKGROUND/AIMS
The aim of the present study was to evaluate the relationship between thyroid hormone levels and infarct severity in patients with ST-elevation myocardial infarction (STEMI).
METHODS
We retrospectively reviewed thyroid hormone levels, infarct severity, and the extent of transmurality in 40 STEMI patients evaluated via contrast-enhanced cardiac magnetic resonance imaging.
RESULTS
The high triiodothyronine (T3) group (> or = 68.3 ng/dL) exhibited a significantly higher extent of transmural involvement (late transmural enhancement > 75% after administration of gadolinium contrast agent) than did the low T3 group (60% vs. 15%; p = 0.003). However, no significant difference was evident between the high- and low-thyroid-stimulating hormone/free thyroxine (FT4) groups. When the T3 cutoff level was set to 68.3 ng/dL using a receiver operating characteristic curve, the sensitivity was 80% and the specificity 68% in terms of differentiating between those with and without transmural involvement. Upon logistic regression analysis, high T3 level was an independent predictor of transmural involvement after adjustment for the presence of diabetes mellitus (DM) and the use of glycoprotein IIb/IIIa inhibitors (odds ratio, 40.62; 95% confidence interval, 3.29 to 502; p = 0.004).
CONCLUSIONS
The T3 level predicted transmural involvement that was independent of glycoprotein IIb/IIIa inhibitor use and DM positivity.

Keyword

Triiodothyronine; Myocardial infarction; Magnetic resonance imaging

MeSH Terms

Aged
Area Under Curve
Biological Markers/blood
Chi-Square Distribution
Contrast Media/diagnostic use
Coronary Angiography
Female
Humans
Logistic Models
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction/blood/*diagnosis/pathology/radiography
Myocardium/*pathology
Odds Ratio
Predictive Value of Tests
ROC Curve
Retrospective Studies
Severity of Illness Index
Thyroxine/blood
Triiodothyronine/*blood
Biological Markers
Contrast Media
Thyroxine
Triiodothyronine