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Effect of thyroid stimulating hormone on the prognosis of coronary heart disease
Ning Ding1,2,3, Rui Hua1,2,3, Hanqing Guo4
1Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Insights
Thyroid stimulating hormone (TSH) levels predict major adverse cardiovascular events (MACE) and mortality in coronary heart disease patients. Even within normal ranges, TSH impacts cardiovascular health and heart failure risk.
Area of Science:
- Endocrinology
- Cardiology
- Clinical Research
Background:
- Thyroid stimulating hormone (TSH) is linked to cardiovascular disease (CVD) risk and mortality.
- Elevated TSH levels, even within normal ranges, can negatively impact cardiovascular function.
Purpose of the Study:
- To assess the predictive value of admission fasting serum TSH levels for long-term MACE and all-cause mortality in coronary heart disease (CHD) patients.
Main Methods:
- 3515 CHD patients were stratified into four TSH level groups.
- MACE and all-cause mortality were compared across groups.
- Restricted quartic splines and Cox regression analyzed TSH concentration risks.
Main Results:
- Patients in the second TSH group (1.03-1.71 mIU/L) showed lower MACE incidence.
- The third TSH group (1.72-2.84 mIU/L) had lower all-cause mortality.
- TSH concentrations were associated with heart failure risk.
Conclusions:
- Admission TSH levels are predictive of adverse cardiovascular events in CHD patients.
- TSH levels can help stratify risk for MACE, mortality, and heart failure in this population.
Introduction:
Clinical studies have shown that thyroid stimulating hormone (TSH) is associated with increased cardiovascular disease risk and mortality. Even within normal ranges, elevated TSH levels have an impact on the cardiovascular system and have been associated with cardiac dysfunction. The aim of our study was to evaluate the predictive value of admission fasting serum TSH levels in patients with coronary heart disease in relation to long-term major adverse cardiovascular events (MACE) and all-cause mortality.
Method:
A total of 3515 patients with coronary heart disease who met the inclusion criteria were divided into four groups according to the quantile of TSH levels: Group 1 (TSH, 0.34-1.02 mIU/L, n=878); Group 2 (TSH, 1.03-1.71 mIU/L, n=886); Group 3 (TSH, 1.72-2.84 mIU/L, n=880); and Group 4 (TSH, 2.86-5.50 mIU/L, n=873). MACE and all-cause mortality were also compared. TSH concentrations associated with the risk of MACE, all-cause mortality were assessed using continuous scales (restricted quartic splines) and Cox proportional hazards regression models.
Results:
A total of 3515 patients with coronary heart disease were eligible for analysis. At a median follow-up of 70 months, patients in group 2 had a lower incidence of MACE compared to the other three groups. All-cause mortality was lower in the 3rd group. Restricted quartic spline analysis also revealed that TSH concentrations were associated with heart failure risk.
Discussion:
TSH levels have predictive value for adverse cardiovascular events and heart failure in patients with coronary heart disease.
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