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Pol. Merkur. Lek (Pol. Med. J.), 2019, XLVII/278: 045-051 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2019, XLVII/278: 045-051

Title: Low triiodothyronine syndrome and serum selenium status in the course of acute myocardial infarction 

Authors: Frączek-Jucha M, Szlósarczyk B, Kabat M, Czubek U, Nessler J, Gackowski A. 

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN ENGLISH.

Low triiodothyronine syndrome and serum selenium status in the course of acute myocardial infarction


Frączek-Jucha M1,2,3, Szlósarczyk B3, Kabat M1,3, Czubek U3, Nessler J1,3, Gackowski A1,3.

1Jagiellonian University Medical College, Department of Coronary Disease and Heart Failure, Krakow, Poland; 2Jagiellonian University Medical College, Department of Emergency Medical Care, Krakow, Poland; 3John Paul II Hospital, Department of Coronary Disease and Heart Failure, Krakow, Poland

Both glutathione peroxidase and deiodinases are selenoproteins requiring selenium. Oxidative stress accompanying acute myocardial infarction (MI) may lead to activation of peroxidase and relative selenium deficiency. That may impair conversion of tetraiodothyronine (T4) to triiodothyronine (T3).
The aim of the study
was the evaluation of the prevalence of low T3 syndrome in MI, in relation to selenium deficiency.
Material and methods
. The study group consisted of 59 consecutive patients hospitalized due to STEMI or NSTEMI, treated with primary percutaneous coronary intervention. Exclusion criteria: thyroid dysfunction, severe systemic disease, treatment with amiodarone, steroids or propranolol. Group A consisted of 7 patients with low fT3 concentration, Group B consisted of remaining 52 patients with normal fT3 levels.
Results
. The prevalence of low T3 syndrome was 11.9%. The prevalence of selenium deficiency was 71.2%. Patients with low T3 syndrome had higher heart rate at admission and more often needed intravenous diuretics or inotropic agents. Low fT3 group presented higher levels of NT-proBNP, hsCRP, WBC, admission CKMB levels. There was a nonsignificant trend towards lower selenium levels in A group. We demonstrated correlations between fT3 and hsTnT, CKMB, NT-proBNP, hsCRP, MAPSE but we did not find correlation between fT3 and selenium or LVEF.
Conclusions
. Selenium deficiency was found in majority of MI patients, while low T3 was identified in 11.9% of patients. fT3 levels correlate with markers of infarction severity and inflammatory markers. Se deficiency alone does not explain the reason of low fT3 concentration.

Key words: myocardial infarction, low T3 syndrome, triiodothyronine, selenium

Pol Med J, 2019; XLVII (278); 45–51