Determination And Clinical Significance Of Thyroid Hormone Levels In Patients With Unstable Angina And Acute Myocardial Infarction

Objective:More and more evidence shows that thyroid hormone homeostasis is easy to be broken in acute or chronic major diseases,including low T3 syndrome,hyperthyroidism and hypothyroidism.This study aims to explore the changes of thyroid hormone levels in patients with unstable angina pectoris and acute myocardial infarction,so as to explore whether the thyroid hormone homeostasis is broken in patients with acute coronary syndrome.Objective to explore the relationship between serum CK-MB,Tn I,BNP levels and thyroid hormone in patients with acute myocardial infarction,so as to explore whether thyroid hormone levels have reference value in the assessment of myocardial infarction and cardiac function changes.Methods:A total of 114 patients with unstable angina and acute myocardial infarction(AMI)diagnosed by coronary angiography from December 2016 to December 2017 in Baoding first central hospital within 12 hours due to chest pain,precordial discomfort and other symptoms were collected,including 53 patients with unstable angina pectoris(UA)and 53 patients with acute myocardial infarction(AMI),There were 61 cases of AMI.General information such as gender,age,height,weight,smoking history,hypertension and diabetes history were recorded.Myocardial enzymes were monitored and the maximum value of CK-MB was recorded after admission.Venous blood samples were collected in the morning of the next day under fasting state to determine the five items of thyroid function,blood lipid(TC,TG,LDL-C),renal function(CR),myocardial infarction(TNI)and heart failure(BNP)and plasma D-dimer.Results:1.There were no significant differences in gender,age,BMI,smoking history,hypertension history,diabetes history,TC,TG,LDL-C,Cr and plasma D-dimer between the two groups(P > 0.05).2.The levels of free triiodothyronine(FT3)and serum total triiodothyronine(TT3)in AMI group were lower than those in UA group,and the difference was statistically significant(P < 0.05).The levels of TT4,FT4 and TSH in AMI group were not statistically significant(P > 0.05).3.Pearson correlation analysis of thyroid hormone and CK-MB,Tn I in patients with acute myocardial infarction FT3 was negatively correlated with CK-MB(r =-0.391,P = 0.002),Tn I(r =-0.348,P = 0.006),TT3,TT4,FT4,TSH were not correlated with,CK-MB,Tn I.4.Pearson correlation analysis of serum BNP and thyroid hormone levels in patients with acute myocardial infarction serum BNP was negatively correlated with FT3 level(r =-0.401,P = 0.001),and negatively correlated with TT3 level(r =-0.345,P = 0.007),but not with TT4,FT4 and TSH.5.Analysis of predictive value of serum FT3 and TT3 levels in patients with myocardial infarction: ROC curve was drawn based on the relationship between FT3,TT3 levels and the occurrence of AMI in the two groups.The AUC of FT3 for predicting AMI was 0.731(95% CI: 0.64-0.83,P < 0.01),and that of TT3 was 0.701(95% CI: 0.60-0.80,P < 0.01).Conclusion:ESS is present in patients with acute myocardial infarction,and FT3TT3 level has certain reference value for the assessment of the disease condition and the change of cardiac function in patients with acute myocardial infarction.