Dysthyroidism and acute coronary syndrome – outcome and prognostic implications

Objective: To establish the prevalence of thyroid dys-function in a well defined sample of patients with ma-nifest coronary heart disease. We analyzed the seve-rity and the type of coronary lesions and the severity of myocardial dysfunction correlated with the level of thyroid hormones
Methods: We examined 32 pacients with from Cardi-ology Clinic of Bagdasar-Arseni Emergency Hospital. The following standardized examinations were performed: Weight, blood pressure were measured. Chest pain was quantified. Venous blood samples drawn in fasting state were used for biochemical laboratory analysis: to-tal, HDL cholesterol, triglycerides, and glucose, thyroid stimulating hormone, free thyroxine, hemoglobin. Mi-ocardial function was analized by echocardiographic parameters. Statistical analysis of the data was done using software SPSS 17.0. The significance of differen-ces among hypothyroid and euthyroid subjects were evaluated by Fisher’s test for categorical variables and by Mann-Whitney U test for continuous variables Results: We found the overall prevalence disthyroi-dism (hypothyroidism) in our sample of patients with manifest coronary heart disease, and we established the relation between thyroid function and coronary lesions and myocardial function. The SYNTAX score, an angi-ographic tool for grading the complexity of coronary artery disease, was found to be a strong predictor of outcome in patients and remaines significantly associ-ated with the risk of cardiac death. Hypercholesterole-mia in hypothyroidism probably results from reduced catabolism of lipoproteins, a phenomenon that may be explained by a decreased expression of lipoprotein re-ceptors
Conclusions: Thyroid dysfunction has to be conside-red a highly prevalent condition, mainly in females, which could potentially contribute to the overall co-ronary risk and may be amenable to secondary pre-ventive interventions. Hypothyroidism has been gene-rally considered a cardiovascular risk factor in many studies, mainly because of its association with elevated serum total and LDL-cholesterol. Whether L-thyroxine supplementation in mild hypothyroid patients could reduce the cardiovascular risk is currently unknown.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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