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Subclinical Hypothyroidism and Clinical Outcomes After Percutaneous Coronary Intervention: A Meta-Analysis

Song Peng Ang1, Jia Ee Chia2, Vikash Jaiswal3

  • 1Division of Internal Medicine, Rutgers Health/Community Medical Center, Toms River, New Jersey.

Current Problems in Cardiology
|March 26, 2023
PubMed

Insights

Subclinical hypothyroidism (SCH) increases cardiovascular mortality and repeat revascularization risk in patients undergoing percutaneous coronary intervention (PCI). Euthyroid patients face lower risks for these adverse outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • Subclinical hypothyroidism (SCH) is linked to cardiovascular mortality, but its impact on patients undergoing percutaneous coronary intervention (PCI) remains unclear.
  • This study investigates the association between SCH and clinical outcomes in patients after PCI.

Approach:

  • A systematic review and meta-analysis was conducted using data from PubMed, Embase, Scopus, and CENTRAL databases up to April 1, 2022.
  • Included studies compared outcomes between SCH and euthyroid patients undergoing PCI.
  • Risk ratios (RR) and 95% confidence intervals (CI) were calculated using a random-effects model.

Key Points:

  • Patients with SCH showed significantly higher risks of cardiovascular mortality (RR 2.16, 95% CI: 1.38-3.38) and all-cause mortality (RR 1.68, 95% CI: 1.23-2.29) compared to euthyroid patients.
  • Repeat revascularization risk was also elevated in the SCH group (RR 1.96, 95% CI: 1.08-3.58).
  • No significant differences were observed for myocardial infarction (MI), major adverse cardiovascular and cerebrovascular events (MACCE), or heart failure between the groups.

Conclusions:

  • Subclinical hypothyroidism is associated with increased cardiovascular and all-cause mortality in patients undergoing PCI.
  • The findings suggest that SCH is a significant risk factor for adverse cardiovascular outcomes post-PCI, particularly concerning mortality and the need for repeat revascularization.

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