ETA2023 45th Annual Meeting of the European Thyroid Association ETA 2023 Oral Session 11: Autoimmunity / Hyperthyroidism (5 abstracts)
Effects of acute triiodothyronine treatment in patients with anterior myocardial infarction undergoing primary angioplasty: does infarct size matter?
Constantinos Pantos 1 , Konstantinos Grigoriou 2 , Athanasios Trikas 1 , Evangelos Pissimisis 3 , Pavlos Stougiannos 2 , Antonios Dimopoulos 3 , Sarantos Linardakis 3 , Nikolaos Alexopoulos 4 , Costas Evdoridis 2 , Gerasimos Gavrielatos 5 , Nikolaos Patsourakos 3 , Nikolaos Papakonstantinou 3 , Anastasios Theodosis-Georgilas 3 & Iordanis Mourouzis 6
1National and Kapodistrian University of Athens, Pharmacology, Greece; 2Elpis General Hospital of Athens, Cardiology; 3Tzaneio General Hospital of Piraeus, Cardiology; 4Iaso Hospital of Athens, Athens Euroclinic, Radiology; 5Bioclinic Athens, Adult Cardiology, Interventional, Iraklio, Greece; 6National and Kapodistrian University of Athens, Pharmacology, Athens, Greece
Objectives: Triiodothyronine (LT3) administration for 48hours in patients undergone primary angioplasty showed favourable effects on cardiac function and remodelling early after myocardial infarction (Thy-Repair, EudraCT 2016-000631-40, Thyroid 2022 Jun;32(6):714-724). The present study investigated whether this beneficial effect was dependent on the severity of infarct size. The extent of infarct size is one of the main determinants of morbidity and mortality after myocardial infarction.
Methods: This is a post hoc analysis which included data from 41 patients participating in the Thy-Repair (n =20 placebo and n =21 LT3). LT3 treatment started after stenting as an intravenous (i.v.) bolus injection of 0.8μg/kg of LT3 followed by a constant infusion of 0.113μg/kg/h i.v. for 48 hours. All patients had CMR at hospital discharge and end-points were left ventricular (LV) ejection fraction (LVEF), LV end-diastolic volume index (LVEDVi), LV end-systolic volume index (LVESVi), Left Ventricular Mass Index (LVMI) and Infarct Volume (IV). Patients were divided in two groups based on the median value of the infarct size; small infarct size with IV≤20% of the LV and large infarct size with IV>20% of the LV.
Results: In patients with small infarct size, LVEF, LVEDVi, LVESVi and IV at discharge were similar in both placebo and T3 treated group. In patients with large infarct size, despite similar IV, LVEDVi and LVESVi were significantly reduced while LVEF was significantly increased in T3 treated group vs placebo.
| Small Infarct Size | Large Infarct Size | |||
| Placebo (n =11) | LT3 (n =8) | Placebo (n =10) | LT3 (n =13) | |
| LVMI, g/m2 | 59.7±16.1 | 56.3±9.4 | 66.6±16.0 | 58.3±6.1 |
| LVEDVi, ml/m2 | 90.9±19.8 | 92.8±14.5 | 112±23.8 | 91.8±18.6* |
| LVESVi, ml/m2 | 40.8±18.2 | 44.9±14.1 | 68.3±21.5 | 49.0±14.0* |
| LVEF, % | 56.8±10.2 | 52.2±10.5 | 39.9±8.7 | 47.3±6.5* |
| Infarct Volume, ml | 14.0±11.8 | 16.8±3.8 | 39±10.7 | 35±8.0 |
| Normal distribution of variables was estimated with Shapiro-Wilk test of normality. Normally distributed data were compared using an independent t-test.* P < 0.05 vs placebo with large infarct size | ||||
Conclusion: These data indicate that the favourable effects of acute LT3 treatment on cardiac function and remodelling early after myocardial infarction is mainly observed in patients with large infarct size. This is of therapeutic relevance since postinfarcted cardiac remodelling frequently occurs in this group of patients.
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Endocrine Abstracts
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