Association of free Tri-iodothyronine Level with Cardiogenic Shock and Prognosis in Patients Hospitalized with Acute STelevation Myocardial Infarction Treated with Streptokinase Therapy

Bangladesh Heart Journal Pub Date : 2023-07-08 DOI:10.3329/bhj.v38i1.67187

S. Huda, A. Choudhury, J. Jahan, Masuma Tabassum, Atikur Rahman, D. Debnath

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Abstract

Background: Cardiogenic shock is the leading cause of death in patients with Acute ST-segment Elevation Myocardial Infarction (STEMI). Low free Tri-iodothyronine (FT3) levels are generally associated with poor prognosis in STEMI patients. This study was done to assess the association between FT3 levels and Cardiogenic shock in patients hospitalized with STEMI treated with streptokinase therapy. Methods: This was an observational study of 140 patients of STEMI treated with streptokinase therapy in the department of cardiology, NICVD, Dhaka, Bangladesh from October 2018 to September 2019. The patients were divided into low FT3 (FT3 <3.5pmol/L; n = 70) and normal FT3 (FT3 e” 3.5pmol/L; n = 70) groups according to FT3 levels measured within 24 hours after admission. Results: During the index hospitalization period, 30 patients developed cardiogenic shock, 23(32.9%) in low FT3 group and 7(10.0%) in normal FT3 group. There were 17 deaths with 18.6% in low FT3 group and 5.7% in normal FT3 group (p=0.01). MACE occurred 45.7% in low FT3 group and 18.6%in normal FT3 group (p=0.001). The mortality in patients with cardiogenic shock was 43.3% compared to 3.6% in patients without cardiogenic shock. Multivariate logistic regression analysis showed FT3 level was an important predictor for cardiogenic shock in patients hospitalized with STEMI (p=0.01). Conclusion: Low FT3 levels were strongly associated with cardiogenic shock in patients with STEMI. The FT3 level screening may be a simple and valuable way to predict Cardiogenic shock after STEMI. Bangladesh Heart Journal 2023; 38(1): 1-7

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链激酶治疗急性st升高型心肌梗死住院患者游离三碘甲状腺原氨酸水平与心源性休克及预后的关系

背景:心源性休克是急性st段抬高型心肌梗死(STEMI)患者死亡的主要原因。游离三碘甲状腺原氨酸(FT3)水平低通常与STEMI患者预后不良相关。本研究旨在评估接受链激酶治疗的STEMI住院患者FT3水平与心源性休克之间的关系。方法:这是一项观察性研究，研究对象是2018年10月至2019年9月在孟加拉国达卡NICVD心内科接受链激酶治疗的140例STEMI患者。将患者分为低FT3组(FT3 <3.5pmol/L;n = 70)和正常FT3 (ft3e”3.5pmol/L;n = 70)根据入院后24小时内测量的FT3水平分组。结果:指数住院期间发生心源性休克30例，低FT3组23例(32.9%)，正常FT3组7例(10.0%)。死亡17例，FT3低组18.6%，FT3正常组5.7% (p=0.01)。低FT3组MACE发生率为45.7%，正常FT3组为18.6% (p=0.001)。心源性休克患者的死亡率为43.3%，而非心源性休克患者的死亡率为3.6%。多因素logistic回归分析显示，FT3水平是STEMI住院患者心源性休克的重要预测因子(p=0.01)。结论:低FT3水平与STEMI患者心源性休克密切相关。FT3水平筛查可能是预测STEMI后心源性休克的一种简单而有价值的方法。孟加拉国心脏杂志2023;38 (1): 1 - 7

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Bangladesh Heart Journal

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