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ȣ - 490634 235 |
| Prevalence and Clinical Significance of Subclinical Hypothyroidism in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents |
| Cardiovascular Center, Korea University Guro Hospital¹ , Korea University Ansan Hospital² , Korea University Anam Hospital³ |
| Seung-Woon Rha¹, Soon Yong Suh¹ , Uk Yeol Chwe¹ , Jin Won Kim¹ , Jeong Cheon Ahn² , Woo Hyuk Song² , Chang Gyu Park¹ , Hong Seog Seo¹ , Dong Joo Oh¹ , Young Moo Ro³ |
Background: Subclinical hypothyroidism is known to be associated with left ventricular dysfunction, dyslipidemia, atrial arrhythmia, and cardiovascular death. We investigated the prevalence of subclinical hypothyroidism in significant coronary artery disease (CAD) who underwent contemporary percutaneous coronary intervention (PCI) using drug-eluting stents (DES) and its relationship with various biological markers and in-hospital clinical end points.
Methods: A total 296 patients (pts, Male 158, mean age 62.1 ± 4.2 years) treated with DES were enrolled. Subclinical hypothyroidism was defined as mildly increased serum thyrotropin hormone (TSH>2.5µIU/ml) and normal thyroid hormone. We investigated the prevalence of subclinical hypothyroidism and compared the subclinical hypothyroidism group (Group 1, n=50) to euthyroid group (Group 2, n=246) in terms of various biological and clinical indices.
Results: Conventional coronary risk factors and smoking and lipid profiles were not different between two groups. The prevalence of subclinical hypothyroidism was 16.9% (50/296). In the Group 1, mean TSH level was 9.48±5.4µIU/ml (Reference; 0.78-1.70) and free T4 was 1.19±0.1ng/ml (Reference; 0.17-4.05). Left ventricular ejection fraction (LVEF) was lower in group 1 (49.6±14.5 vs. 51.3±10.7% in Group 2, p=0.01). Glycosylated hemoglobin (HbA1C; 8.19±9.8 % of THb vs. 6.76±1.9, p=0.007) and hs-CRP (1983 mg/L vs. 1049 mg/L, p=0.008) were higher in Group 1. Other biological markers such as ESR, homocysteine, pro-B type natriuretic peptide (BNP), CO-Hb, LP(a), and Fibrinogen levels were not different between the two groups. Early clinical outcomes including death, myocardial infarction, revascularization and major adverse cardiac events are not different between the two groups.
Conclusion: The prevalence of subclinical hypothyroidism in significant CAD was 16.9%. Uncontrolled diabetes, high CRP and LV dysfunction appears to be associated with subclinical hypothyroidism whereas biological markers for inflammation and artherosclerosis and other clinical outcomes need to be reevaluated with larger study population.
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