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The Prognostic Value of Thyroid-Stimulating Hormone in Patients with Coronary Artery Disease and Depression
1Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
Insights
Higher thyroid-stimulating hormone (TSH) levels are linked to increased major adverse cardiovascular events (MACE) in patients with both coronary artery disease (CAD) and depression. Further research is needed to confirm this association and explore TSH-lowering treatments.
Area of Science:
- Cardiology
- Endocrinology
- Psychiatry
Background:
- Comorbidity of coronary artery disease (CAD) and depression is common, associated with poor prognosis.
- The relationship between thyroid-stimulating hormone (TSH) and major adverse cardiovascular events (MACE) in this patient group is not well understood.
Purpose of the Study:
- To investigate the association between baseline TSH levels and the occurrence of MACE in patients with comorbid CAD and depression.
Main Methods:
- 203 patients with CAD (confirmed by coronary angiography) and depression symptoms were enrolled.
- Patients were divided into high TSH (≥ 1.395μIU/mL) and low TSH (< 1.395μIU/mL) groups.
- Follow-up averaged 23.7 months to assess MACE occurrence.
Main Results:
- TSH levels demonstrated discriminatory power for MACE (AUC = 0.61, P = 0.03).
- The high TSH group exhibited a significantly higher risk of MACE (P = 0.029).
- This association persisted after multi-factor adjustment (HR = 2.05, P = 0.028).
Conclusions:
- Elevated TSH levels are associated with an increased risk of MACE in patients with comorbid CAD and depression.
- Further research is warranted to validate this finding and explore therapeutic interventions targeting TSH reduction.
Purpose:
Patients with the comorbidity of coronary artery disease (CAD) and depression are very common and always have poor prognosis. The relationship between thyroid-stimulating hormone (TSH) levels and major cardiovascular event (MACE) in these patients is still unknown. We aimed to explore this association.
Patients And Methods:
We enrolled 203 CAD patients proven by coronary angiography (CAG). In the meanwhile, they were all assessed to have depression symptom by professional psycho-cardiologists. After an average follow-up of 23.7 months, patients were divided into two groups (high TSH group with TSH ≥ 1.395μIU/mL and low TSH group with TSH < 1.395μIU/mL) according to the cut-off value of baseline TSH. The impact of two different TSH groups for adverse events in CAD patients with depression was evaluated.
Results:
The average age of these patients was 64.9 years old. The two TSH groups had no significant difference in the comparison of other baseline data. Area under the receiver operating characteristic (ROC) curves (AUC) analysis indicated the well-discriminatory power of TSH levels for the occurrence of MACE (AUC = 0.61, 95% CI: 0.52-0.70, P = 0.03). In the KM survival analysis, high TSH group had a higher risk of MACE (P = 0.029). After multi-factor adjustment, there still existed a higher risk of MACE in high TSH group (HR = 2.05, 95% CI: 1.08-3.88, P = 0.028).
Conclusion:
In patients with the comorbidity of CAD and depression, higher TSH levels are associated with the occurrence of MACE. More researches need to be conducted to prove this association and explore whether the drug-related TSH reduction can decrease the occurrence of adverse events in the future.
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