Effect of Low T3 Syndrome on Severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome: A Cross-sectional Study
Published: May 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/60298.17824
Basavaraj Devendrappa Baligar, Sateeshkumar Bapugouda Patil, Ishwar Siddappa Hasabi, Anand Koppad
1. Assistant Professor, Department of Cardiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
2. Postgraduate Student, Department of General Medicine, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
3. Professor and Head, Department of General Medicine, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
4. Associate Professor, Department of General Medicine, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
Correspondence
Sateeshkumar Bapugouda Patil,
Dhavalagi, Tq: Muddebihal Dist: Vijayapur-586116, Karnataka, India.
E-mail: docsatishpatil1743@gmail.com
Introduction: Low Triiodothyronine (T3) syndrome is a hormonal imbalance that significantly influences cardiovascular haemodynamics by altering the vascular endothelial function through the Nitric Oxide (NO) pathway. In Acute Coronary Syndrome (ACS), inflammation disrupts plaque, which stimulates thrombosis, coagulation, activation of the sympathetic system, and release of cytokines, mainly Interleukin 6 (IL-6), a pleotropic and pro-inflammatory cytokine that exerts inhibitory effects on thyroid axis function.
Aim: To study the association of low T3 syndrome and severity of Coronary Artery Disease (CAD) in ACS.
Materials and Methods: This cross-sectional study was conducted in the Intensive Critical Care Unit (ICCU) under the Department of Cardiology at Karnataka Institute of Medical Sciences, Hubli, Karnataka, India, from July 2021 to August 2022. A total of 120 consecutive ACS patients who underwent Coronary Angiography (CAG) were included in the study. The severity of CAD was assessed using the Gensini risk scoring, system, and the patients were divided based on their thyroid function status. Low T3 syndrome was defined as <0.846 ng/mL with normal values of Thyroxine (T4) and Thyroid Stimulating Hormone (TSH). Receiver operating characteristic curves were generated to correlate low T3 syndrome and angiographic severity of CAD. Multinomial logistic regression analysis demonstrated that LT3S is an independent risk factor for CAD. The Chi-square test was used for ordered categorical data with the severity of coronary artery lesions.
Results: The severity of coronary artery lesions in the low T3 syndrome group (n=29, 24.16%) and hypothyroidism (n=20, 16.6%) group was significantly greater than that of the euthyroid group (n=71, 59.1%), with all groups showing statistical significance (p-value=0.047). Multinomial logistic regression analysis demonstrated that low T3 syndrome was an independent risk factor for moderate (Odds ratio=2.34, 95% CI: 0.47-11.39, p<0.02) and severe (Odds ratio=8.56, 95% CI: 1.52-47.9, p<0.015) lesions.
Conclusion: The results of this study suggest that patients with low T3 syndrome are associated with more severe and diffuse CAD and low T3 syndrome is an independent risk factor for ACS.
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