“Association of Low Free T3 Levels with Stroke Pattern, Severity and Outcome in Patients with Acute Ischemic Stroke”

Abstract

Background: Acute ischemic stroke (AIS) is a major global health burden, leading to significant morbidity and mortality. Recent studies indicate a potential link between free triiodothyronine (fT3) levels and stroke prognosis, with the "low T3 syndrome" emerging as a possible marker of poor outcomes in critically ill patients. However, its specific role in AIS remains underexplored, warranting further investigation into its impact on stroke severity, recovery, and long-term neurological function. This study aimed to investigate the association between low fT3 levels and stroke pattern, severity, and functional outcome in patients with AIS.

Material & Method: A prospective cohort study was conducted at Aarupadai Veedu Medical College & Hospital over 18 months, including 100 patients diagnosed with AIS. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and functional outcomes were evaluated using the Modified Rankin Scale (mRS). Free T3 levels were measured within 48 hours of admission. Statistical analysis included correlation and regression models to assess associations between fT3 levels, stroke severity, and outcomes.

Results: The study population had a mean age of 59.66 ± 11.8 years, with a male predominance (59%). Anterior circulation stroke was more prevalent (75%) than posterior stroke (25%). A significant negative correlation was observed between fT3 levels and NIHSS scores (r = -0.317, p < 0.05), as well as fT3 levels and mRS scores (r = -0.314, p < 0.05), indicating that lower fT3 levels were associated with greater stroke severity and poorer functional outcomes. Additionally, NIHSS and mRS scores showed a strong positive correlation (r = 0.878, p < 0.05).

Conclusion: Low fT3 levels were significantly associated with more severe strokes and worse functional outcomes in AIS patients. These findings suggest that fT3 may serve as a prognostic biomarker in stroke management. Further studies are required to explore potential therapeutic interventions targeting thyroid hormone modulation in AIS.