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Dysfunction of Thyroid Hormones Following Acute Coronary Syndrome in a Tertiary Care Hospital in Dhaka City
1Dr Azizun Nahar, Associate Professor of Microbiology, Bangladesh Medical College (BMC), Dhaka, Bangladesh;
Insights
Thyroid hormone abnormalities are common in acute coronary syndrome (ACS) patients. Monitoring thyroid function, specifically TSH levels, may help predict prognosis in ACS patients.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Thyroid hormones are crucial for cardiovascular homeostasis.
- Acute coronary syndrome (ACS) encompasses conditions like unstable angina/non-ST elevated myocardial infarction (UA/NSTEMI) and ST-elevated myocardial infarction (STEMI).
- Understanding the thyroid hormone profile in ACS patients is essential for risk stratification and management.
Purpose of the Study:
- To investigate thyroid hormone profile changes in ACS patients.
- To compare thyroid function between UA/NSTEMI and STEMI groups.
- To assess the correlation between abnormal thyroid function and ACS risk.
Main Methods:
- A descriptive, cross-sectional study involving 83 ACS patients admitted to a Coronary Care Unit.
- Collected data included cardiac markers (Troponin-I), ECG, CBC, glucose, renal function tests, lipid profile, thyroid profile, and echocardiography.
- Patients were categorized into UA/NSTEMI and STEMI groups for comparative analysis.
Main Results:
- Abnormal thyroid function was observed in 18.07% of ACS patients.
- While 29.41% of STEMI patients had abnormal thyroid function compared to 10.20% in the UA/NSTEMI group, this difference was not statistically significant (p=0.025).
- Common comorbidities included hypertension (32.53%), diabetes (26.50%), and chronic kidney disease (19.27%).
Conclusions:
- Thyroid hormone profile abnormalities are prevalent in ACS patients.
- Abnormal thyroid function is associated with an increased risk of coronary artery disease.
- Measuring TSH levels upon hospital admission may aid in evaluating ACS prognosis.
Abstract:
In cardiovascular homeostasis thyroid hormone plays an important role. We planned to study the changes in thyroid hormone profile in acute coronary syndrome patients admitted in the coronary care unit and compare them between two groups: unstable angina/non-ST elevated Myocardial infarction (UA/NSTEMI) and ST elevated Myocardial infarction (STEMI). This study was a hospital based descriptive cross sectional study which was conducted from 01 March 2018 to 01 February 2019 in Coronary Care Unit of Bangladesh Medical College Hospital and laboratory tests were done in Microbiology Department of Bangladesh Medical College, Dhaka, Bangladesh. Eighty three cases of acute coronary syndromes were taken for the study. Troponin-I was measured as cardiac marker, Electrocardiogram, Complete blood count, blood glucose level, Blood urea, serum creatinine, serum electrolytes, Fasting lipid profile, Thyroid profile, Echocardiography 2D were done. Most of the respondents were distributed in age group 46-60 years where 34(64.15%) male and 19(35.85%) female. Out of 83 Acute Coronary Syndrome (ACS) patients, 27(32.53%) hypertensive, 22(26.50%) diabetic and 16(19.27%) were Chronic kidney disease (CKD). Abnormal lipid profile was present in 30(43.47%) patients. Among total 52 male and 31 female 9(17.30%) male and 6(19.35%) female had abnormal thyroid function. We further elaborated abnormal thyroid function tests in STEMI group and UA/Non STEMI group of ACS patients. We found 10 patients in STEMI group and 5 patients in UA/Non STEMI group with abnormal thyroid function 29.41% and 10.20% respectively which was not statistically significant (p=0.025). This study depicts abnormality in thyroid hormone profile in 18.07% patients of ACS. Abnormal thyroid function increases risk of coronary artery disease. TSH level of ACS patients on hospital admission could be helpful to evaluate further prognosis of the disease.
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