title: Relation of Low T3 to One-Year Mortality in Non-ST-Elevation Acute Coronary Syndrome Patients.
abstract: BACKGROUND
  Low T3 which is defined as decreased triiodothyronine (T3) and normal thyroid-stimulating hormone (TSH) and thyroxin (T4) levels is present in many acute diseases and is related to increased mortality. We studied low T3 level's relation to long-term mortality in non-ST-elevation acute coronary syndrome (NSTE-ACS) patients.
  
  
  METHODS
  T3, T4, and TSH levels of consecutive NSTE-ACS patients were measured. Patients with normal T4 and TSH levels, but low T3 level were defined as low T3 group. Patients with normal T3, T4, and TSH levels were defined as normal group. Clinical and laboratory findings in these two groups were compared. In addition, we examined low T3 level's relation to early and long-term mortality.
  
  
  RESULTS
  Mean patient age was 61 ± 13 (67% male) and 31 (11%) patients had low T3 level. Free T3 values were negatively correlated with age, serum creatinine, and brain type natriuretic peptide values at the time of admission (r = -0.452, P < 0.0001; r = -0.255, P < 0.0001; r = -0.544, P < 0.0001, respectively). Mortality at 1 month and 1 year was higher in low T3 group (3% vs. 16%, P = 0.002; 6.4% vs. 23%, P = 0.003, respectively). In multivariate analysis, low T3 was found to be related to mortality at 1 year (OR: 2.6, 95% CI: 1.1-6.5, P = 0.02). In ROC analysis, free T3 had a good area under the curve (AUC) value for mortality at 1 year [AUC: 0.709 (95% CI: 0.619-0.799, SE: 0.0459)].
  
  
  CONCLUSIONS
  Low T3 is related to increased early and late mortality in NSTE-ACS patients. Free T3 levels may be used to identify NSTE-ACS patients with high mortality risk.
authors: Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey.
authors: Selçuk
authors: S
authors: Yazıcı
authors: Ataturk Training and Research Hospital, Katip Celebi University, Cardiology Clinic, İzmir, Turkey.
authors: Tuncay
authors: T
authors: Kırış
authors: Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey.
authors: Ufuk S
authors: US
authors: Ceylan
authors: Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey.
authors: Sait
authors: S
authors: Terzi
authors: Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey.
authors: Aysun
authors: A
authors: Erdem
authors: Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey.
authors: Işıl
authors: I
authors: Atasoy
authors: Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey.
authors: Ayşe
authors: A
authors: Emre
authors: Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey.
authors: Kemal
authors: K
authors: Yeşilçimen
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000401:mortality*; D000368:Aged; D019540:Area Under Curve; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D012372:ROC Curve; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood*
chemical_list: D014284:Triiodothyronine; D020097:Natriuretic Peptide, Brain; D013972:Thyrotropin; D003404:Creatinine; D013974:Thyroxine
keywords: acute coronary syndrome; free T3; prognosis