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Adawiyah J, Norasyikin AW, Mat NH, et al. The non-thyroidal illness syndrome in acute coronary syndrome is associated with increased cardiac morbidity and mortality. Heart Asia. 2010;2(1):11-4doi: 10.1136/ha.2009.001503.
Adawiyah, J., Norasyikin, A. W., Mat, N. H., Shamsul, A. S., & Azmi, K. N. (2010). The non-thyroidal illness syndrome in acute coronary syndrome is associated with increased cardiac morbidity and mortality. Heart Asia, 2(1), 11-4. https://doi.org/10.1136/ha.2009.001503
Adawiyah, J, et al. "The non-thyroidal illness syndrome in acute coronary syndrome is associated with increased cardiac morbidity and mortality." Heart Asia vol. 2,1 (2010): 11-4. doi: https://doi.org/10.1136/ha.2009.001503
Adawiyah J, Norasyikin AW, Mat NH, Shamsul AS, Azmi KN. The non-thyroidal illness syndrome in acute coronary syndrome is associated with increased cardiac morbidity and mortality. Heart Asia. 2010 Jul 06;2(1):11-4. doi: 10.1136/ha.2009.001503. eCollection 2010. PMID: 27325934; PMCID: PMC4898515.
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Heart Asia. 2010 Jul 06;2(1):11-4. doi: 10.1136/ha.2009.001503. eCollection 2010.

The non-thyroidal illness syndrome in acute coronary syndrome is associated with increased cardiac morbidity and mortality.

Heart Asia

J Adawiyah, A W Norasyikin, N H Mat, A S Shamsul, K Nor Azmi

Affiliations

  1. Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Kuala Lumpur, Malaysia.
  2. Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Kuala Lumpur, Malaysia; Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Kuala Lumpur, Malaysia.

PMID: 27325934 PMCID: PMC4898515 DOI: 10.1136/ha.2009.001503

Abstract

INTRODUCTION: The non-thyroidal illness syndrome (NTIS) or the sick euthyroid syndrome refers to abnormal changes in circulating thyroid hormones due to systemic illnesses. Thyroid hormones are pivotal in the regulation of normal cardiac functions. However, the effects of the NTIS on the heart in acute coronary syndrome (ACS) are still unclear.

METHODS: A 6-month prospective cohort study involving 85 patients admitted with ACS was carried out. TSH, FT4 and FT3 were assessed on days 1, 5 and 42. Antithyroid peroxidase antibodies, antithyroglobulin antibodies, fasting blood sugar, HbA1c and fasting serum lipid were obtained on admission. Mortality, functional status (Killip and New York Heart Association Classifications), arrhythmias and readmission rate were recorded.

RESULTS: The prevalence of NTIS was 53%. It was seen in 48% of unstable angina (UA), 54% of non-ST elevation myocardial infarction (NSTEMI) and 56% of ST elevation myocardial infarction (STEMI) patients. NTIS is associated with cardiovascular mortality, all-cause mortality, severe heart failure and a higher readmission rate. The levels of FT3 correlate with severity of myocardial damage as measured by CK and Troponin T. Lower TSH was seen in the non-survivors and in those with ventricular arrhythmias. The most common presentation of NTIS was low FT3 (43.5%), followed by low TSH (12.9%) and FT4 (4.7%). None of the predisposing factors analysed were associated with the development of NTIS.

CONCLUSIONS: NTIS in patients with ACS is associated with increased cardiovascular mortality and morbidity, and affects UA, NSTEMI and STEMI equally.

Keywords: Non-thyroidal illness syndrome (NTIS); acute coronary syndrome

References

  1. Thyroid. 1996 Aug;6(4):255-9 - PubMed
  2. J Clin Endocrinol Metab. 1997 Feb;82(2):329-34 - PubMed
  3. Arch Med Res. 1992 Autumn;23(3):143-7 - PubMed
  4. Br J Haematol. 1993 Dec;85(4):778-82 - PubMed
  5. J Clin Endocrinol Metab. 1999 Jan;84(1):151-64 - PubMed
  6. Cardiology. 1995;86(2):152-6 - PubMed
  7. Arch Intern Med. 2002 Jun 24;162(12):1388-94 - PubMed
  8. Clin Endocrinol (Oxf). 1990 Dec;33(6):777-86 - PubMed
  9. Ann Intern Med. 1983 Jun;98(6):946-57 - PubMed
  10. Am J Med. 2001 Dec 15;111(9):699-703 - PubMed
  11. Clin Sci (Lond). 1984 Dec;67(6):585-90 - PubMed
  12. Clin Endocrinol (Oxf). 1993 Nov;39(5):499-518 - PubMed
  13. Ann Thorac Surg. 1991 Jul;52(1):46-50 - PubMed
  14. J Trauma. 1984 Feb;24(2):116-9 - PubMed
  15. J Clin Endocrinol Metab. 2005 Dec;90(12):6498-507 - PubMed
  16. J Clin Endocrinol Metab. 1995 Mar;80(3):971-6 - PubMed
  17. Angiology. 2002 Nov-Dec;53(6):699-707 - PubMed
  18. Metabolism. 1986 Apr;35(4):289-91 - PubMed

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