Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction
Objectives: To study the relationship between serum-free T3 (FT3), C-reactive protein (CRP) and all-cause mortality in patients with acute myocardial infarction (AMI). Design: Prospective multicentre longitudinal cohort study. Methods: Between December 2014 and December 2016, thyroid function an...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2023-01-01
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| Series: | European Thyroid Journal |
| Subjects: | |
| Online Access: | https://etj.bioscientifica.com/view/journals/etj/11/2/ETJ-21-0085.xml |
| _version_ | 1797955233889910784 |
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| author | Salman Razvi Avais Jabbar Arjola Bano Lorna Ingoe Peter Carey Shahid Junejo Honey Thomas Caroline Addison David Austin John P Greenwood Azfar G Zaman |
| author_facet | Salman Razvi Avais Jabbar Arjola Bano Lorna Ingoe Peter Carey Shahid Junejo Honey Thomas Caroline Addison David Austin John P Greenwood Azfar G Zaman |
| author_sort | Salman Razvi |
| collection | DOAJ |
| description | Objectives: To study the relationship between serum-free T3 (FT3), C-reactive protein (CRP) and all-cause mortality in patients with acute myocardial infarction (AMI).
Design: Prospective multicentre longitudinal cohort study.
Methods: Between December 2014 and December 2016, thyroid function and CRP were analysed in AMI (both ST-elevation (STEMI) and non-ST-elevation) patients from the Thyroxine in Acute Myocardial Infarction study. The relationship of FT3 and CRP at baseline with all-cause mortality up to June 2020 was assessed. Mediation analysis was performed to evaluate if CRP mediated the relationship between FT3 and mortality.
Results: In 1919 AMI patients (29.2% women, mean (s.d.) age: 64.2 (12.1) years and 48.7% STEMI) followed over a median (interquartile range) period of 51 (46–58) months, there were 277 (14.4%) deaths. Overall, lower serum FT3 and higher CRP levels were associated with higher risk of mortality. When divided the patients into tertiles based on the levels of FT3 and CRP; the group with the lowest FT3 and highest CRP levels had a 2.5-fold increase in mortality risk (adjusted hazard ratio (95% CI) of 2.48 (1.82–3.16)) compared to the group with the highest FT3 and lowest CRP values. CRP mediated 9.8% (95% CI: 6.1–15.0%) of the relationship between FT3 and mortality.
Conclusions: In AMI patients, lower serum FT3 levels on admission are associated with a higher mortality risk, which is partly mediated by inflammatio n. Adequately designed trials to explore the potential benefits of T3 in AMI patients a re required. |
| first_indexed | 2024-04-10T23:30:02Z |
| format | Article |
| id | doaj.art-c02b6ff8e65c43acb3e235cad14a2002 |
| institution | Directory Open Access Journal |
| issn | 2235-0802 |
| language | English |
| last_indexed | 2024-04-10T23:30:02Z |
| publishDate | 2023-01-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj.art-c02b6ff8e65c43acb3e235cad14a20022023-01-12T07:53:36ZengBioscientificaEuropean Thyroid Journal2235-08022023-01-01112110https://doi.org/10.1530/ETJ-21-0085Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarctionSalman Razvi0Avais Jabbar1Arjola Bano2Lorna Ingoe3Peter Carey4Shahid Junejo5Honey Thomas6Caroline Addison7David Austin8John P Greenwood9Azfar G Zaman10Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK; Department of Endocrinology, Gateshead Health NHS Foundation Trust, Gateshead, UK Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK; Department of Cardiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK Department of Cardiology, Institute of Social and Preventive Medicine, University of Bern, Bern University Hospital, Bern, SwitzerlandDepartment of Endocrinology, Gateshead Health NHS Foundation Trust, Gateshead, UKDepartments of Endocrinology and Cardiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UKDepartments of Endocrinology and Cardiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UKDepartment of Cardiology, Northumbria Healthcare NHS Foundation Trust, Cramlington, UKDepartment of Biochemistry, Gateshead Health NHS Foundation Trust, Gateshead, UKDepartment of Cardiology, South Tees Health NHS Foundation Trust, Middlesbrough, UKLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UKTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK; Department of Cardiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK Objectives: To study the relationship between serum-free T3 (FT3), C-reactive protein (CRP) and all-cause mortality in patients with acute myocardial infarction (AMI). Design: Prospective multicentre longitudinal cohort study. Methods: Between December 2014 and December 2016, thyroid function and CRP were analysed in AMI (both ST-elevation (STEMI) and non-ST-elevation) patients from the Thyroxine in Acute Myocardial Infarction study. The relationship of FT3 and CRP at baseline with all-cause mortality up to June 2020 was assessed. Mediation analysis was performed to evaluate if CRP mediated the relationship between FT3 and mortality. Results: In 1919 AMI patients (29.2% women, mean (s.d.) age: 64.2 (12.1) years and 48.7% STEMI) followed over a median (interquartile range) period of 51 (46–58) months, there were 277 (14.4%) deaths. Overall, lower serum FT3 and higher CRP levels were associated with higher risk of mortality. When divided the patients into tertiles based on the levels of FT3 and CRP; the group with the lowest FT3 and highest CRP levels had a 2.5-fold increase in mortality risk (adjusted hazard ratio (95% CI) of 2.48 (1.82–3.16)) compared to the group with the highest FT3 and lowest CRP values. CRP mediated 9.8% (95% CI: 6.1–15.0%) of the relationship between FT3 and mortality. Conclusions: In AMI patients, lower serum FT3 levels on admission are associated with a higher mortality risk, which is partly mediated by inflammatio n. Adequately designed trials to explore the potential benefits of T3 in AMI patients a re required.https://etj.bioscientifica.com/view/journals/etj/11/2/ETJ-21-0085.xmltriiodothyronineinflammationmortalityacute myocardial infarction |
| spellingShingle | Salman Razvi Avais Jabbar Arjola Bano Lorna Ingoe Peter Carey Shahid Junejo Honey Thomas Caroline Addison David Austin John P Greenwood Azfar G Zaman Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction European Thyroid Journal triiodothyronine inflammation mortality acute myocardial infarction |
| title | Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction |
| title_full | Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction |
| title_fullStr | Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction |
| title_full_unstemmed | Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction |
| title_short | Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction |
| title_sort | triiodothyronine t3 inflammation and mortality risk in patients with acute myocardial infarction |
| topic | triiodothyronine inflammation mortality acute myocardial infarction |
| url | https://etj.bioscientifica.com/view/journals/etj/11/2/ETJ-21-0085.xml |
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