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July 10, 1996

Triiodothyronine and Cardiac Surgery-Reply

Author Affiliations

Duke University Medical Center Durham, NC

JAMA. 1996;276(2):100-101. doi:10.1001/jama.1996.03540020022014

In Reply.  —We studied the effect of intravenous T3 in patients undergoing coronary artery bypass graft surgery at significant risk for postoperative inotropic support as determined by the Duke Cardiovascular Data Bank. Indeed, the high incidence of inotropic drug use in the control group of our study reconfirmed our inclusion criteria.Approximately half of the patients in the placebo group from our study and from a similar study by Klemperer et al1 required postoperative inotropic drugs, which demonstrates that both studies selected patients at high risk for requiring inotropic agents. While our study did not demonstrate an inotropic effect of T3 in this patient population, it is possible (based on results from various animal studies2,3) that patients with more severe disease (eg, ischemic cardiomyopathy or severely depressed ventricular function) might benefit from T3. Arguing against this point, however, is the lack of T3 effect in the