Abstract
Background: Neuroendocrine changes are important processes which accompany critical illness, however, the number of clinical studies concentrating on the role of thyroid gland hormones in stroke pathogenesis is relatively small. The aim of this prospective study was to investigate the relation between free triiodothyronine (fT3) levels and the prognosis of patients with stroke.
Methods: The prospective study included 387 patients with acute (<24 h of symptoms onset) ischemic stroke consecutively admitted to Stroke Units. The subjects with known conditions that could interfere with thyroid gland metabolism were excluded. We analyzed: the routine blood tests, fT3, free thyroxine (fT4), thyroid-stimulating hormone (TSH) levels, unenhanced CT scans, initial clinical status (NIH Stroke Scale, NIHSS), 30- and 360- days outcome (modified Rankin Scale-mRS) and calculated the survival rate.
Results: A higher NIHSS score was in the 1st fT3 levels tertile, whereas a lower in the 3rd fT3 levels tertile (p=0.006). The 30- and 360-days mRS scores showed that patients in the lowest fT3 tertile had more severe neurological impairment than those in the highest tertile (p=0.001 and p=0.03, respectively). A 1-year mortality of the patients with the first tertile fT3 levels was significantly higher than that of the patients with the third tertile hormone levels (p=0.008). Additionally, subjects with fT3 level in the lowest tertile demonstrated higher WBC counts and the ventricular system on Computed Tomography of head performed on admission to hospital was statistically more frequent compressed than that in the patients with fT3 level in the highest tertile (p=0.02 and p=0.03, respectively).
Conclusion: In acute stroke patients lower free T3 levels are an important factor related to unfavorable outcome, i. e., severe disability and death.
Key words
triiodothyronine - nonthyroidal illness syndrome - cerebrovascular disease
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Correspondence
W. Ambrosius
Department of Neurology
Poznan University of Medical
Sciences
Przybyszewskiego St. 49
60–355 Poznan
Poland
Phone: +48/61/869 1535
Fax: +48/61/869 1697
Email: wambrosius@amp.edu.pl
