Impact of baseline free serum triiodothyronine on stroke severity and outcome in patients with atherothrombotic ischemic stroke

Authors

  • D. Filimonov State Institution “V.K. Gusak Institute of Urgent and Reparative Surgery”; L.M. Litvinenko Institute of Physical Organic Chemistry and Coal Chemistry, Kyiv, Ukraine
  • A. Yeresko L.M. Litvinenko Institute of Physical Organic Chemistry and Coal Chemistry, Kyiv, Ukraine
  • A. Fedorova State Institution “V.K. Gusak Institute of Urgent and Reparative Surgery”, Kyiv, Ukraine
  • V. Marusichenko State Institution “V.K. Gusak Institute of Urgent and Reparative Surgery”, Kyiv, Ukraine
  • M. Belotserkovskaya State Institution “V.K. Gusak Institute of Urgent and Reparative Surgery”, Kyiv, Ukraine
  • N. Trubnikova State Institution “V.K. Gusak Institute of Urgent and Reparative Surgery”, Kyiv, Ukraine

DOI:

https://doi.org/10.22141/2224-0713.16.2.2020.200960

Keywords:

ischemic stroke, outcome, thyroid hormones, triiodothyronine

Abstract

Background. According to recent studies, thyroid hormones may have various effects on stroke severity, course and outcome, but underlying mechanisms of this association are still unclear. The purpose was to determine the relationship of thyroid hormones during stroke onset with stroke severity and outcome in a clinical study. Materials and methods. In this study, 168 adult patients with acute ischemic stroke were enrolled. Concentrations of free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone and basic stroke risk factors were assessed during 24 h from symptoms onset. Neurological deficit was evaluated by Scandinavian Stroke Scale (SSS). Disabling deficit was defined as Modified Rankin Scale score ≥ 3 points six months after stroke. Results. ANOVA showed that SSS scores were significantly higher in patients with fT3 level in quartile IV (≥ 5.35 pmol/l) compared to quartiles II–III (SSS median 48 vs. 37, p = 0.0481) and especially to quartile I (≤ 3.4050 pmol/l, SSS median 48 vs. 30, p = 0.0018). In patients without prior stroke (n = 124), fT3 independently affected baseline SSS score (corrected R2 = 0.49, p < 0.0001). The analysis showed that in patients with atherothrombotic stroke subtype (n = 108), fT3 level was an independent risk factor for unfavourable stroke outcome (odds ratio = 0.3498, 95% confidence interval 0.1235–0.9904). According to ROC-analysis, fT3 level < 4.44 pmol/l was a predictor of disabling deficit (AUC = 0.727, specificity — 96.4 %, sensitivity — 66.8 %, p = 0.003). Conclusions. The study showed that a low serum free triiodothyronine level during stroke onset negatively affects the stroke severity in first stroke patients and may be a predictor of its unfavourable outcome. In patients with atherothrombotic stroke, lower baseline fT3 levels were independently associated with poor outcome after 6 months. Beneficial effects of additional fT3 supplement during stroke should be assessed in future studies.

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Published

2021-11-16

How to Cite

Filimonov, D., Yeresko, A., Fedorova, A., Marusichenko, V., Belotserkovskaya, M., & Trubnikova, N. (2021). Impact of baseline free serum triiodothyronine on stroke severity and outcome in patients with atherothrombotic ischemic stroke. INTERNATIONAL NEUROLOGICAL JOURNAL, 16(2), 28–35. https://doi.org/10.22141/2224-0713.16.2.2020.200960

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Original Researches