Usefulness of Serum Triiodothyronine (T3) to Predict Outcomes in Patients Hospitalized With Acute Heart Failure

If you want your FT3 tested, see a cardiac doctor...

It surely would be ironic if FT3 tests get classified as heart tests rather than endocrine due to the speiclaties using it extensively.

The next question, does giving such patients T3 help?

Am J Cardiol. 2016 Nov 16. pii: S0002-9149(16)31819-7. doi: 10.1016/j.amjcard.2016.10.045. [Epub ahead of print]

Usefulness of Serum Triiodothyronine (T3) to Predict Outcomes in Patients Hospitalized With Acute Heart Failure.

Rothberger GD1, Gadhvi S2, Michelakis N2, Kumar A3, Calixte R4, Shapiro LE5.

Author information

1Division of Endocrinology, Winthrop-University Hospital, Mineola, New York. Electronic address: grothberger@winthrop.org.

2Division of Cardiology, Winthrop-University Hospital, Mineola, New York.

3Department of Pathology, Winthrop-University Hospital, Mineola, New York.

4Department of Biostatistics, Winthrop-University Hospital, Mineola, New York.

5Division of Endocrinology, Winthrop-University Hospital, Mineola, New York.

Abstract

Thyroid hormone plays an important role in cardiac function. Low levels of serum triiodothyronine (T3) due to nonthyroidal illness syndrome may have adverse effects in heart failure (HF). This study was designed to assess the ability of T3 to predict in-hospital outcomes in patients with acute HF. In total, 137 patients without thyroid disease or treatment with drugs which affect TH levels, who were hospitalized with acute HF were prospectively enrolled and studied. TH levels were tested upon hospital admission, and outcomes were compared between patients with low (<2.3 pg/ml) and normal (≥2.3 pg/ml) free T3 levels as well as between those with low (<0.6 ng/ml) and normal (≥0.6 ng/ml) total T3 levels. Low free T3 correlated with an increased length of stay in the hospital (median 11 vs 7 days, p <0.001) and higher rates of intensive care unit admission (31.8% vs 16.9%, p = 0.047), with a trend toward increased need for invasive mechanical ventilation (9.0% vs 1.4%, p = 0.056). Low total T3 correlated with an increased length of stay in the hospital (median 11 vs 7 days, p <0.001) and increased need for invasive mechanical ventilation (9.8% vs 1.3%, p = 0.045). In conclusion, low T3 predicts worse hospital outcomes in patients with acute HF and can be useful in the risk stratification of these patients.

Copyright © 2016 Elsevier Inc. All rights reserved.

PMID: 28017303

DOI: 10.1016/j.amjcard.2016.10.045

[PubMed - as supplied by publisher]

ncbi.nlm.nih.gov/pubmed/280...

2 Replies

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  • Thanks Helvella for this important information. Most probably that's why I had all the heart sensations without having a heart problem. T3 certainly removed all of the symptoms and I've not had an ECG since (thankfully).

    Is it not surprising therefore that a FT3 and FT4 isn't done on those who are as yet undiagnosed with hypothyroidism due to doctors only taking into account TSH and T4 and ignoring symptoms?

  • I mentioned thyroid treatment and low T3 to a cardiologist and she seriously told me "T3 is bad for the heart". I was new to the whole thyroid issue at the time and didn't bother arguing with her because I felt I was on very shaky ground. Sadly, now I'm less new to thyroid issues I still wouldn't argue with her, but it would be because I would assume it was a waste of time. :(

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