Abstract
Aim:
To investigate the relationship between free triiodothyronine (FT3) and the international normalized ratio (the ratio of the prothrombin time of a patient to the normal sample, INR) in Chinese euthyroid subjects with acute ST-segment elevation myocardial infarction (STEMI).
Methods:
A total of 231 consecutive patients (177 males, 54 females) with STEMI were enrolled. Anthropometric and laboratory measurements, including heart rate, respiratory rate, blood pressure, body temperature, platelet count, INR, prothrombin time, activated partial thromboplastin time, FT3, free thyroxine (FT4), and thyroid-stimulating hormone, were collected from all the patients. The levels of FT3 and FT4 were measured with a full-automatic immune analyzer. The INR was determined using a coagulation analyzer.
Results:
Patients were classified into 4 groups according to their quartile FT3 and FT4 levels: 0.40–3.09 (n=52), 3.10–3.69 (n=56), 3.70–4.29 (n=64) and 4.30–7.10 (n=59) for FT3; 4.9–14.8 (n=57), 14.9–16.8 (n=58), 16.9–18.7 (n=57) and 18.8–29.0 (n=59) for FT4. Subjects with a high FT3 level had significantly lower values of INR than those with a low FT3 level (P=0.01). Multiple linear regression analysis revealed decreased serum FT3 as an independent risk factor for elevated INR values (β=-0.139, P=0.025). The value of INR was similar among the 4 groups according to the quartile FT4 levels (P=0.36).
Conclusion:
Free triiodothyronine was negatively associated with INR in the patients with acute STEMI and normal thyroid function.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Greenfield WS . Autopsy findings in a 58 year old woman with myxoedema public hed as an appendix. Ord WM Med Chir Trans 1878; 61: 57
Cappola AR, Ladenson PW . Hypothyroidism and atherosclerosis. J Clin Endocr Metab 2003; 88: 2438–44.
Kocher T . Ueber Kropfexstirpation und ihre Folgen. Arch Klein Cir 1883; 29: 254–337.
Squizzato A, Gerdes VE, Brandjes DP, Büller HR, Stam J . Thyroid diseases and cerebrovascular disease. Stroke 2005; 36: 2302–10.
Marongiu F, Cauli C, Mariotti S . Thyroid, hemostasis and thrombosis. J Endocrinol Invest 2004; 27: 1065–71.
Gullu S, Sav H, Kamel N . Effects of levothyroxine treatment on biochemical and hemostasis parameters in patients with hypothyroidism. Eur J Endocrinol 2005; 152: 355–61.
Smyth CJ . Angina pectoris and myocardial infarctlon as complications of myxedema. Am Heart J 1938: 15: 652–60.
Wayne EJ . Clinical and metabolic studies in thyroid disease. Br Med J 1960: 1: 78–90.
2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care — Part 8: Stabilization of the Patient With Acute Coronary Syndromes. Circulation 2005; 112: IV-89-IV-110.
Wong CK, White HD . Antithrombotic therapy in ST-segment elevation myocardial infarction. Expert Opin Pharmacother 2011; 12: 213–23.
Squizzato A, Romualdi E, Büller HR, Gerdes VE . Thyroid dysfunction and effects on coagulation and fibrinolysis: a systematic review. J Clin Endocrinol Metab 2007; 92: 2415–20.
Lippi G, Franchini M, Targher G, Montagnana M, Salvagno GL, Guidi GC, et al. Hyperthyroidism is associated with shortened APTT and increased fibrinogen values in a general population of unselected outpatients. J Thromb Thrombolysis 2009; 28: 362–5.
Franchini, M, Lippi G, Manzato F, Vescovi PP, Target G . Hemostatic abnormalities in endocrine and metabolic disorders. Eur J Endocrinol 2010; 162: 439–51.
Bucerius J, Naubereit A, Joe AY, Ezziddin S, Biermann K, Risse J, et al. Subclinical hyperthyroidism seems not to have a significant impact on systemic anticoagulation in patients with coumarin therapy. Thromb Haemost 2008; 100: 803–9.
Smallridge RC . Disclosing subclinical thyroid disease. An approach to mild laboratory abnormalities and vague or absent symptoms. Postqrad Med 2000; 107: 143–6, 149–52.
Corsonello A, Montesanto A, Berardelli M, De Rango F, Dato S, Mari V Mazzei B, et al. A cross-section analysis of FT3 age-related changes in a group of old and oldest-old subjects, including centenarians' relatives, shows that a down-regulated thyroid function has a familiar component and is related to longevity. Age Ageing 2010; 39: 723–7.
Trigo J, Mimoso J, Gago P, Marques N, Faria R, Santos W, et al. Female gender: an independent factor in ST-elevation myocardial infarction. Rev Port Cardiol 2010; 29: 1383–94.
Adler SM, Wartofsky L . The non-thyroidal illness syndrome. Endocrinol Metab Clin North Am 2007; 36: 657–72.
Franchini M, Montagnana M, Manzato F, Vescovi PP . Thyroid dysfunction and hemostasis: an issue still unresolved. Semin Thromb Hemost 2009; 35: 288–94.
Shih CH, Chen SL, Yen CC, Huang YH, Chen CD, Lee YS, et al. Thyroid hormone receptor-dependent transcriptional regulation of fibrinogen and coagulation proteins. Endocrinology 2004; 145: 2804–14.
Iervasi G, Pingitore A, Landi P, Ripoli A, Scarlattini M, L'Abbate A, et al. Low T3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation 2003; 107: 708–13.
Lymvaios I, Mourouzis I, Cokkinos DV, Dimopoulos MA, Toumanidis ST, Pantos C . Thyroid hormone and recovery of cardiac function in patients with acute myocardial infarction: A strong association? Eur J Endocrinol 2011; 165: 107–14.
Everts ME, Verhoeven FA, Bezstarosti K, Moerings EP, Hennemann G, Visser TJ, et al. Uptake of thyroid hormones in neonatal rat cardiac myocytes. Endocrinology 1996; 137: 4235–42.
Debeij J, Cannegieter SC, VAN Zaane B, Smit JW, Corssmit EP, Rosendaal FR, et al. The effect of changes in thyroxine and thyroid-stimulating hormone levels on the coagulation system. J Thromb Haemost 2010; 8: 2823–6.
Acknowledgements
This study was supported by the National Natural Science Foundation of China (No 30400173 and 30971257).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Li, L., Guo, Cy., Yang, J. et al. Negative association between free triiodothyronine level and international normalized ratio in euthyroid subjects with acute myocardial infarction. Acta Pharmacol Sin 32, 1351–1356 (2011). https://doi.org/10.1038/aps.2011.118
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/aps.2011.118
Keywords
This article is cited by
-
Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients
BMC Cardiovascular Disorders (2022)
-
Thyroid hormones and cardiovascular disease
Nature Reviews Cardiology (2017)
-
Cardioprotection and thyroid hormones
Heart Failure Reviews (2016)