Introduction: High-sensitive cardiac troponin reflects micro-myocardial injury in the absence of overt myocardial infarction. Objective: This study aimed to clarify how thyrotoxicosis affects cardiac troponin. Methods: This was a prospective observational study in Japan. Untreated patients with thyrotoxicosis who visited Ito Hospital were enrolled, and medical treatment was initiated for hyperthyroidism. Thyroid function, high-sensitive troponin I (hsTnI), and brain natriuretic peptide (BNP) were measured at baseline and then every 3 months for 1 year. Results: Data from a total of 143 patients (median age, 42 years; 32 men and 111 women) were investigated. At baseline, median hsTnI was 1.9 pg/mL and ranged from 0 to 69.6 pg/mL. Five patients (3.5%) had a high hsTnI value that exceeded 26.2 pg/mL, which is used as the cutoff for diagnosis of myocardial infarction, and 22 patients (15.4%) had an intermediate value between 5.0 and 26.2 pg/mL. Multivariable regression analysis showed that significant predictors of the hsTnI value were age (β = 0.20, p = 0.01) and BNP (β = 0.43, p #x3c; 0.0001) (R² = 0.27, F = 26.0, p #x3c; 0.0001), and significant predictors of the BNP value were age (β = 0.23, p = 0.001), hemoglobin (β = −0.43, p #x3c; 0.0001), free T₄ (FT₄) (β = 0.23, p = 0.001), and hsTnI (β = 0.27, p #x3c; 0.0001) (R² = 0.49, F = 33.8, p #x3c; 0.0001). Correlations were found between a decrease in hsTnI and BNP in the first 3 months (ρ = 0.49, p #x3c; 0.0001). A decrease in FT₄ in the first 3 months was weakly correlated with decreases in hsTnI (ρ = 0.32, p = 0.0004) and BNP (ρ = 0.32; p = 0.0003). Of the 27 patients with elevated hsTnI (≥5.0 pg/mL), the hsTnI level was normalized in 20 patients within a year. Conclusions: In thyrotoxicosis, the myocardial biomarker hsTnI is elevated in about 20% of patients; hsTnI levels decrease as thyroid function improves and BNP decreases.
Eur Thyroid J

中文翻译：

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甲状腺毒症患者的心肌肌钙蛋白升高，随着甲状腺功能的改善和脑利钠肽水平的降低而降低

简介：高敏心肌肌钙蛋白反映了在没有明显心肌梗塞的情况下的微心肌损伤。目的：本研究旨在阐明甲状腺毒症如何影响心肌肌钙蛋白。方法：这是一项在日本进行的前瞻性观察性研究。入组到伊东医院就诊的未经治疗的甲状腺毒症患者，并开始对甲亢进行药物治疗。在基线时测量甲状腺功能、高敏肌钙蛋白 I (hsTnI) 和脑利钠肽 (BNP)，然后每 3 个月测量一次，持续 1 年。结果：共调查了 143 名患者（中位年龄 42 岁；32 名男性和 111 名女性）的数据。基线时，hsTnI 中位数为 1.9 pg/mL，范围为 0 至 69.6 pg/mL。5名患者（3.5%）的hsTnI值超过26.2 pg/mL，作为诊断心肌梗死的临界值，22名患者（15.4%）的值介于5.0和26.2 pg/mL之间。多变量回归分析显示，hsTnI 值的显着预测因子是年龄 (β = 0.20, p = 0.01) 和 BNP (β = 0.43, p #x3c; 0.0001) ( R ² = 0.27, F = 26.0, p #x3c; 0.0001 )，BNP 值的显着预测因子是年龄 (β = 0.23, p= 0.001)、血红蛋白 (β = -0.43, p #x3c; 0.0001)、游离 T ₄ (FT ₄ ) (β = 0.23, p = 0.001) 和 hsTnI (β = 0.27, p #x3c; 0.0001) ( R ² = 0.49，F = 33.8，p #x3c；0.0001）。在前 3 个月发现 hsTnI 和 BNP 下降之间存在相关性（ρ = 0.49，p #x3c；0.0001）。前 3 个月FT ₄的下降与 hsTnI (ρ = 0.32, p = 0.0004) 和 BNP (ρ = 0.32; p= 0.0003)。在 hsTnI 升高（≥5.0 pg/mL）的 27 名患者中，20 名患者的 hsTnI 水平在一年内恢复正常。结论：在甲状腺毒症中，约 20% 的患者的心肌生物标志物 hsTnI 升高；hsTnI 水平随着甲状腺功能的改善和 BNP 的降低而降低。
欧洲甲状腺杂志