Kim Dong Hun, Choi Dong-Hyun, Kim Hyun-Wook, Choi Seo-Won, Kim Bo-Bae, Chung Joong-Wha, Koh Young-Youp, Chang Kyong-Sig, Hong Soon-Pyo
Department of Radiology, Chosun University School of Medicine, Gwangju, Korea.
Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea.
Korean J Intern Med. 2014 Jul;29(4):454-65. doi: 10.3904/kjim.2014.29.4.454. Epub 2014 Jun 27.
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).
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.
The high triiodothyronine (T3) group (≥ 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).
The T3 level predicted transmural involvement that was independent of glycoprotein IIb/IIIa inhibitor use and DM positivity.
背景/目的：本研究旨在评估ST段抬高型心肌梗死（STEMI）患者甲状腺激素水平与梗死严重程度之间的关系。
我们回顾性分析了40例通过对比增强心脏磁共振成像评估的STEMI患者的甲状腺激素水平、梗死严重程度和透壁程度。
高三碘甲状腺原氨酸（T3）组（≥68.3 ng/dL）的透壁累及程度（钆对比剂注射后晚期透壁强化>75%）显著高于低T3组（60%对15%；p = 0.003）。然而，高、低促甲状腺激素/游离甲状腺素（FT4）组之间无明显差异。使用受试者工作特征曲线将T3临界值设定为68.3 ng/dL时，区分有或无透壁累及的敏感度为80%，特异度为68%。经逻辑回归分析，在调整糖尿病（DM）的存在和糖蛋白IIb/IIIa抑制剂的使用后，高T3水平是透壁累及的独立预测因素（比值比，40.62；95%置信区间，3.29至502；p = 0.004）。
T3水平可预测透壁累及，且独立于糖蛋白IIb/IIIa抑制剂的使用和DM阳性情况。
