Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Cardiology, Shanghai Tenth People's Hospital Chongming Branch, Shanghai, China.
Front Endocrinol (Lausanne). 2021 May 31;12:681978. doi: 10.3389/fendo.2021.681978. eCollection 2021.
Low free triiodothyronine (fT3) level is strongly associated with poor prognosis in various patient populations. However, the role of fT3 in the risk of clinical outcomes in myocardial infarction with non-obstructive coronary arteries (MINOCA) has not been studied. Our study aimed to evaluate the association between low fT3 levels and the clinical outcomes of MINOCA patients.
A total of 218 MINOCA patients without a history of thyroid disease were enrolled in the study. Demographic, baseline clinical data, thyroid hormones, and other biochemical parameters were assessed in all patients. According to the fT3 levels, the present study was classified into two groups: the low fT3 group (fT3<3.5 pmol/L) and the normal fT3 group (fT3 3.5-6.5 pmol/L). The endpoint of the study was major adverse cardiac events (MACE).
Fifty-nine patients were in the low fT3 group and 159 patients were in the normal fT3 group. Over the two years of follow-up, 36 MACE have occurred. The occurrence of MACE was higher in the low fT3 group compared with normal fT3 group (25.4% vs 13.2%; P=0.031). Kaplan-Meier survival curves showed a significantly increased risk of MACE in patients with low fT3 (log-rank P=0.027). Multivariable logistic regression analysis stated that high fT3 was independently associated with lower risk of MACE after two years of follow up (OR, 0.623; 95% CI, 0.399- 0.972; P=0.037).
Low fT3 levels were significantly associated with increased risk of MACE in patients with MINOCA. This finding suggests that the fT3 levels may serve as a potential biomarker in risk stratification of MINOCA patients.
游离三碘甲状腺原氨酸（fT3）水平低与各种患者群体的不良预后密切相关。然而，fT3 在心梗伴非阻塞性冠状动脉疾病（MINOCA）患者的临床结局风险中的作用尚未得到研究。我们的研究旨在评估低 fT3 水平与 MINOCA 患者临床结局之间的关系。
共纳入 218 例无甲状腺疾病病史的 MINOCA 患者。所有患者均评估了人口统计学、基线临床数据、甲状腺激素和其他生化参数。根据 fT3 水平，本研究分为两组：低 fT3 组（fT3<3.5 pmol/L）和正常 fT3 组（fT3 3.5-6.5 pmol/L）。研究的终点是主要不良心脏事件（MACE）。
低 fT3 组 59 例，正常 fT3 组 159 例。随访 2 年期间，发生 36 例 MACE。低 fT3 组的 MACE 发生率高于正常 fT3 组（25.4% vs 13.2%；P=0.031）。Kaplan-Meier 生存曲线显示，低 fT3 组 MACE 风险显著增加（log-rank P=0.027）。多变量逻辑回归分析表明，随访 2 年后高 fT3 与 MACE 风险降低独立相关（OR，0.623；95%CI，0.399-0.972；P=0.037）。
低 fT3 水平与 MINOCA 患者 MACE 风险增加显著相关。这一发现表明，fT3 水平可能成为 MINOCA 患者风险分层的潜在生物标志物。
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