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March 17, 2022Thyroid

Effects of Acute Triiodothyronine Treatment in Patients with Anterior Myocardial Infarction Undergoing Primary Angioplasty: Evidence from a Pilot Randomized Clinical Trial (ThyRepair Study)

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Why the study?

Triiodothyronine (T3) improved postischemic cardiac function and limited apoptosis in experimental ischemia, prompting investigation of acute liothyronine (LT3) in anterior myocardial infarction.

Does acute liothyronine (LT3) treatment improve CMR LVEF in patients with anterior myocardial infarction undergoing primary angioplasty?

Population

52 randomized patients with anterior myocardial infarction undergoing primary angioplasty (37 analyzed per protocol)

Comparison

Intravenous liothyronine (LT3) bolus plus 48-hour infusion vs placebo

Design

Pilot randomized double-blind placebo-controlled trial

Follow-up

6 months

Authors

CPConstantinos PantosNational and Kapodistrian University of AthensATAthanasios TrikasEvangelismos HospitalEPEvangelos PissimisisTzaneion General Hospital

Discussion

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Implication

Does not support acute LT3 to improve LVEF after anterior MI; challenges supplementation hypothesis while leaving secondary signals open.

Structured PICO

Does acute liothyronine (LT3) treatment improve CMR LVEF in patients with anterior myocardial infarction undergoing primary angioplasty?

P
Population
52 randomized patients (37 analyzed per protocol) with anterior myocardial infarction undergoing primary angioplasty.
I
Intervention
Liothyronine (LT3) started after stenting as an intravenous bolus injection of 0.8 μg/kg followed by a constant infusion of 0.113 μg/kg/h i.v. for 48 hours.
C
Comparator
Placebo
O
Outcome
Cardiac magnetic resonance (CMR) left ventricular (LV) ejection fraction (LVEF) at 6 months follow-upsurrogate

Acute liothyronine treatment after anterior MI did not significantly improve LVEF at 6 months but showed potential benefits on acute LV volumes and 6-month infarct volume, alongside a possible increased risk of early atrial fibrillation.

Limitations

  • small sample size
  • pilot study

Cite This Study

Pantos et al. (2022) studied this question.

synapsesocial.com/papers/6a853fdf9be126273dd97a16https://doi.org/10.1089/thy.2021.0596
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pharmacological approaches to reperfusion therapy2012 · 27 citations
  2. 2QRS duration and late mortality in unselected post-infarction patients of the revascularization era2005 · 55 citations
  3. 3Heart Failure Complicating Acute Myocardial Infarction; Burden and Timing of Occurrence: A Nation‐wide Analysis Including 86 771 Patients From the Cardiovascular Disease in Norway (CVDNOR) Project2016 · 141 citations
  4. 4CONSORT 2010 statement: extension to randomised pilot and feasibility trials2016 · 3,686 citations
  5. 5Thyroid Hormone Receptor α1 Downregulation in Postischemic Heart Failure Progression: The Potential Role of Tissue Hypothyroidism2010 · 66 citations