Related Experiment Video
Updated: Jul 25, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Normal thyroid stimulating hormone is associated with all-cause mortality in patients with acute myocardial
Wei-Cheng Ni1, Shu-Ting Kong2, Ken Lin1
1Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Insights
Normal thyroid-stimulating hormone (TSH) levels impact cardiovascular health. Higher normal TSH levels in acute myocardial infarction (AMI) patients post-percutaneous coronary intervention (PCI) predict increased mortality risk, especially when combined with GRACE scores.
Area of Science:
- Cardiology
- Endocrinology
- Clinical Research
Background:
- Circulating thyroid-stimulating hormone (TSH) levels within the normal range can influence cardiovascular outcomes.
- The prognostic significance of normal TSH levels in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) requires further investigation.
Purpose of the Study:
- To investigate the prognostic value of normal circulating thyroid-stimulating hormone (TSH) levels in patients presenting with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).
Main Methods:
- 1240 patients with AMI and normal thyroid function were classified into TSH tertiles.
- All-cause mortality was the primary endpoint.
- Integrated discrimination index (IDI) and net reclassification index (NRI) assessed predictive values of TSH and GRACE scores.
Main Results:
- The highest TSH tertile was associated with increased all-cause mortality risk (HR: 1.56) after covariate adjustment.
- TSH levels interacted significantly with GRACE scores, improving mortality prediction, particularly in high-risk patients.
- The addition of TSH levels to GRACE scores enhanced prediction accuracy (NRI=0.239, IDI=0.044).
Conclusions:
- Elevated normal TSH levels are linked to higher all-cause mortality in high-risk AMI patients post-PCI.
- TSH levels can refine risk stratification for AMI patients undergoing PCI.
Background:
Circulating thyroid-stimulating hormone (TSH) levels within the normal reference range can affect the cardiovascular system. The present study investigated the prognostic value of normal TSH levels in patients presenting with acute myocardial infarction (AMI) following percutaneous coronary intervention (PCI).
Methods:
Between January 2013 and July 2019, 1240 patients with AMI and normal thyroid function were enrolled and classified according to TSH tertile. The trial endpoint was all-cause mortality. The integrated discrimination index (IDI) and the net reclassification index (NRI) were used to assess the combined predictive values of the TSH levels and the Global Registry of Acute Coronary Events (GRACE) scores.
Results:
After a median 44.25-month follow-up, 195 individuals died. Even after covariate adjustment by multivariate Cox regression (HR: 1.56; 95% CI 1.08-2.25; P = 0.017), the patients in the third TSH tertile were at the highest risk of all-cause mortality. A subgroup analysis revealed significant interactions between the TSH levels and the GRACE scores (high risk vs. low/medium risk) (P = 0.019). The addition of the TSH levels to the GRACE scores substantially improved the prediction of all-cause mortality, especially for high-risk patients (NRI = 0.239; IDI = 0.044; C-statistic value range 0.649-0.691; all significant).
Conclusions:
The third TSH tertile is associated with a higher incidence of all-cause mortality than the first TSH tertile in high-risk patients presenting with AMI after PCI.
More Related Videos
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:18Functions of Thyroid Hormones
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...