在接受初级皮肤冠状动脉干预的亚临床甲状腺功能低下症患者中短期结局
Abdulameer J Al-Gburi1,2,3, Saba R Al-Obaidi2, Wasnaa H Abdullah3
1Department of Medicine, College of Medicine, al-Mustansiriyah University, Baghdad, Iraq.
Ghana medical journal
|August 14, 2023
概括
在接受初级穿皮冠状动脉干预的ST升高心肌梗塞患者中未诊断的亚临床甲状腺功能低下症与更糟糕的短期结果和30天死亡率的增加有关. 常规的甲状腺功能测试可能有利于早期检测和管理.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 亚临床甲状腺功能低下症是一种以高甲状腺刺激激素水平与正常的自由甲状腺素水平为特征的疾病.
- 它对接受初级穿皮冠状动脉干预 (PCI) 的ST升高心肌梗塞 (STEMI) 患者的影响尚未完全理解.
- 早期识别STEMI患者不良后果的风险因素对于改善预后至关重要.
研究的目的:
- 调查以前未被诊断的亚临床甲状腺功能低下症与伊拉克STEMI患者接受初级PCI的短期结果和死亡率之间的关联.
- 为了确定该患者群体中亚临床甲状腺功能低下症的患病率.
主要方法:
- 进行了一项前性观察队列研究,对257名住院的STEMI患者进行了初级PCI.
- 在住院期间测量了甲状腺刺激激素和自由T4水平.
- 记录了短期心血管和脏不良事件,以及30天死亡率.
主要成果:
- 在14%的STEMI患者中检测到亚临床甲状腺功能低下症,在女性中更常见.
- 患有亚临床甲状腺功能低下症的患者表现出明显更糟糕的短期结果,包括低于最佳的TIMI流量,减少左心室喷射率,更高的Killip类,心脏发生性休克的发生率增加,住院心脏骤停和急性损伤.
- 在亚临床甲状腺功能低下症患者中观察到显著更高的30天死亡率.
结论:
- 以前未被诊断的亚临床甲状腺功能低下症与初级PCI接受STEMI患者的短期不良结果和30天死亡率的增加有显著联系.
- 在住院治疗STEMI期间进行常规甲状腺功能测试可能是有必要的,以识别和管理亚临床甲状腺功能低下症.
- 这些发现强调了在急性心肌梗塞的综合管理中考虑甲状腺状况的重要性.
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