The effect of low FT3 levels on coronary artery calcification and MACE in outpatients with suspected coronary artery disease

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ObjectiveConsiderable evidence suggests that thyroid dysfunction, especially hypothyroidism, may lead to coronary artery disease (CAD). The aim of this study is to investigate the effect of low serum levels of free triiodothyronine (FT3) on coronary artery calcification in outpatients with suspected CAD and the occurrence rate of major adverse cardiac events (MACE) in these patients.MethodsA total of 588 outpatients with suspected CAD were enrolled in this study. The patients’ blood samples were assayed for FT3, free thyroxine, thyroid stimulating hormone and serum lipids. On the basis of FT3 levels, these patients were divided into low FT3 (FT3<3.5 pmol/l; n=127) and normal FT3 (≥3.5 pmol/l; n=461) groups. Coronary artery calcification scores (CACS) were measured using dual-source computed tomography. The occurrence of MACE was recorded during the follow-up period (8–29 months) and their relationship with FT3 levels was investigated.ResultsPatients with low FT3 levels had higher CACS (337.52±339.36 vs. 194.89±347.29, P<0.001) and a higher incidence of MACE (7.9 vs. 2.2%, P=0.002) compared with those with normal FT3 levels (≥3.5 pmol/l). Logistic regression analysis showed that the FT3 levels are inversely associated with CACS (odds ratio=0.463, 95% confidence interval=0.282–0.761, P=0.002) and patients with CACS greater than 100 have lower FT3 levels than those with lower CACS (P<0.001). Kaplan–Meier analysis showed that patients with low FT3 levels have a higher incidence of MACE.ConclusionFT3 levels were inversely associated with CACS and the incidence of MACE in patients with suspected CAD. A low FT3 level was an important predictor of the occurrence of MACE.

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