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Published on: January 28, 2020
Effects of thyroid dysfunction on the severity of coronary artery lesions and its prognosis
Min-fu Bai1, Chuan-yu Gao2, Chao-kuan Yang3
1Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, China.
Insights
Thyroid dysfunction, including low T3 syndrome and hypothyroidism, is linked to a higher prevalence and severity of coronary heart disease (CHD). Patients with these conditions face a worse prognosis and increased cardiac events.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Abnormal thyroid hormone metabolism is associated with coronary heart disease (CHD) development and progression.
- Thyroid dysfunction may impact cardiovascular health, necessitating further investigation into its role in CHD.
Purpose of the Study:
- To investigate the relationship between thyroid dysfunction and the severity of coronary artery lesions.
- To analyze the prognosis of patients with thyroid dysfunction undergoing coronary angiography (CAG).
Main Methods:
- A cohort of 605 patients suspected of having CHD undergoing CAG were categorized into euthyroid, low T3 syndrome, and hypothyroidism groups.
- Coronary artery lesion severity was assessed using Gensini scores.
- Major adverse cardiac events were tracked during a follow-up period.
Main Results:
- Patients with low T3 syndrome and hypothyroidism exhibited a significantly higher prevalence and severity of CHD compared to euthyroid individuals.
- Low T3 syndrome was identified as an independent risk factor for moderate and severe coronary artery lesions.
- Thyroid dysfunction was associated with a significantly worse prognosis, including higher rates of all-cause death, myocardial infarction, and coronary revascularization.
Conclusions:
- Hypothyroidism and low T3 syndrome are prevalent in patients with CHD.
- These thyroid conditions are associated with increased coronary artery lesion severity and poorer clinical outcomes.
- Screening for thyroid dysfunction in patients with suspected CHD is warranted to improve patient prognosis.
Background:
Abnormal thyroid hormone metabolism influences the occurrence and progress of coronary heart disease (CHD). The aim of the present study was to analyze the severity of coronary artery lesions and the prognosis of thyroid dysfunction patients admitted for coronary angiography (CAG).
Methods:
From July 2011 to July 2012, 605 consecutive patients with suspected coronary heart disease admitted for CAG were selected. The patients were divided into three groups, based on their thyroid function prior to CAG: euthyroid group (n=455 patients), low T3 syndrome group (n=96 patients), and hypothyroidism group (n=54 patients). All patients underwent CAG. Then the severity of coronary artery lesions was assessed by Gensini scores. All patients were followed up for major adverse cardiac events.
Results:
The prevalence of CHD in low T3 syndrome group and hypothyroidism group was significantly higher than that in the euthyroid group (p<0.001 and p=0.004, respectively). Moreover, the severity of coronary artery lesions in low T3 syndrome group and hypothyroidism group was significantly greater than that in the euthyroid group (all p<0.001). Multinomial logistic regression analysis demonstrated that low T3 syndrome was an independent risk factor of coronary artery moderate [odds ratio (OR)=4.268, 95% CI: 3.294-7.450, p=0.016] and severe (OR=4.294, 95% CI: 2.259-9.703, p<0.001) lesions. The mean duration of follow-up was 15.3±3.8 months; patients with thyroid dysfunction had a significantly worse prognosis as compared to those in the euthyroid group for the composite end-point (p<0.01). Moreover, the incidence of the composite end-point (all-cause death, non-fatal myocardial infarction, and coronary revascularization) was significantly higher in low T3 syndrome group and hypothyroidism group compared with that of in the euthyroid group (all p<0.001).
Conclusions:
The patients with hypothyroidism and low T3 syndrome had a high prevalence of CHD, increased severity of coronary artery lesions and poor prognosis.
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