Effects of thyroid dysfunction on the severity of coronary artery lesions and its prognosis

Bai, Minfu; Gao, Chuanyu; Yang, Chao-Kuan; Wang, Xianpei; Li, Jun; Qi, Datun; Zhang, You; Hao, Peiyuan; Li, Muwei

doi:10.1016/j.jjcc.2014.03.009

Cited by 23 publications

(14 citation statements)

References 22 publications

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“… AF atrial fibrillation, CI confidence interval, HF heart failure, IHD ischemic heart disease, MI myocardial infarction, RR relative risk, RT replacement therapy a P value for heterogeneity b Large cohort studies with >10,000 population c High-quality studies with a total score of ≥6 d Outlier studies found by sensitivity analyses (hetred command); there were 2 for cardiac mortality, 8 for all-cause mortality, 1 for stroke, 1 for HF, 1 for AF, and 1 for total cardiovascular events e Three cohort studies did not report the estimates: Aho et al [ 21 ] (cardiovascular mortality), Bai et al [ 20 ] (IHD, all-cause mortality, MI), Parle et al [ 19 ] (all-cause mortality) …”

Section: Resultsmentioning

confidence: 99%

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What is the association of hypothyroidism with risks of cardiovascular events and mortality? A meta-analysis of 55 cohort studies involving 1,898,314 participants

Ning

Cheng

Liu

et al. 2017

BMC Med

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BackgroundWhether hypothyroidism is an independent risk factor for cardiovascular events is still disputed. We aimed to assess the association between hypothyroidism and risks of cardiovascular events and mortality.MethodsWe searched PubMed and Embase from inception to 29 February 2016. Cohort studies were included with no restriction of hypothyroid states. Priori main outcomes were ischemic heart disease (IHD), cardiac mortality, cardiovascular mortality, and all-cause mortality.ResultsFifty-five cohort studies involving 1,898,314 participants were identified. Patients with hypothyroidism, compared with euthyroidism, experienced higher risks of IHD (relative risk (RR): 1.13; 95% confidence interval (CI): 1.01–1.26), myocardial infarction (MI) (RR: 1.15; 95% CI: 1.05–1.25), cardiac mortality (RR: 1.96; 95% CI: 1.38–2.80), and all-cause mortality (RR: 1.25; 95% CI: 1.13–1.39); subclinical hypothyroidism (SCH; especially with thyrotropin level ≥10 mIU/L) was also associated with higher risks of IHD and cardiac mortality. Moreover, cardiac patients with hypothyroidism, compared with those with euthyroidism, experienced higher risks of cardiac mortality (RR: 2.22; 95% CI: 1.28–3.83) and all-cause mortality (RR: 1.51; 95% CI: 1.26–1.81).ConclusionsHypothyroidism is a risk factor for IHD and cardiac mortality. Hypothyroidism is associated with higher risks of cardiac mortality and all-cause mortality compared with euthyroidism in the general public or in patients with cardiac disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0777-9) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…e Three cohort studies did not report the estimates: Aho et al [ 21 ] (cardiovascular mortality), Bai et al [ 20 ] (IHD, all-cause mortality, MI), Parle et al [ 19 ] (all-cause mortality)…”

Section: Resultsmentioning

confidence: 99%

What is the association of hypothyroidism with risks of cardiovascular events and mortality? A meta-analysis of 55 cohort studies involving 1,898,314 participants

Ning

Cheng

Liu

et al. 2017

BMC Med

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“…In patients with ACS, a decrease in serum triiodothyronine (T3), as well as the impaired conversion of thyroxine (T4) into T3, have been reported [8,9]. Thyroid hormone related indicators are also predictors for thrombus burden [10], severity of coronary artery lesions [11,12], cardiac function [13,14] and myocardial injury size [8,9,15] in ACS patients. However, the screening and treatment of mild thyroid dysfunction is still controversial [16][17][18][19][20] and not recommended for ACS patients [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Association between mild thyroid dysfunction and clinical outcome in acute coronary syndrome undergoing percutaneous coronary intervention

et al. 2020

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Background: Thyroid hormones profoundly influence the cardiovascular system, but the effects of mild thyroid dysfunction on the clinical outcome of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) are not well defined. This study aimed to determine the effect of mild thyroid dysfunction on 12-month prognosis in ACS patients undergoing PCI. Methods: In this prospective cohort study with a 12-month follow-up, 1560 individuals were divided into four groups based on thyroid hormone levels upon admission: euthyroidism (used as a reference group), subclinical hypothyroidism, subclinical hyperthyroidism, and low triiodothyronine syndrome (low T3 syndrome). The outcomes measured were all-cause mortality, cardiac mortality, nonfatal reinfarction, and unplanned repeat revascularization. Results: In this study, the prevalence of mild thyroid dysfunction was 10.8%. Multivariate analysis showed that low T3 syndrome, but not subclinical hypothyroidism or subclinical hyperthyroidism, was associated with a higher rate of all-cause (HR 2.553,, p = 0.030) and cardiac mortality (HR 2.594,, p = 0.034), compared with the euthyroidism group. Conclusions: Mild thyroid dysfunction was frequent in patients with ACS undergoing PCI. Low T3 syndrome was the predominant feature and was associated with 12-month adverse outcomes in these patients.

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“…Perturbations in the hypothalamus-pituitary-thyroid (HPT) axis affect stroke risk and stroke outcomes. Hypothyroidism can cause hypertension, hypercholesterolemia, cardiac dysfunction, and both hypo- and hypercoagulability, all of which are risk factors for stroke [ 2 – 4 ]. Hyperthyroidism is also associated with atrial fibrillation, which is a common cause of cardioembolic stroke [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Thyroid hormones and functional outcomes after ischemic stroke

et al. 2015

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BackgroundStroke is the fifth leading cause of death and the primary cause of long-term adult disability in the United States. Increasing evidence suggests that low T3 levels immediately following acute ischemic stroke are associated with greater stroke severity, higher mortality rates, and poorer functional outcomes. Prognosis is also poor in critically ill hospitalized patients who have non-thyroidal illness syndrome (NTIS), where T3 levels are low, but TSH is normal. However, data regarding the association between TSH levels and functional outcomes are contradictory. Thus, this study investigated the role of TSH on stroke outcomes, concomitantly with T3 and T4.FindingsIn this work, blood was collected from patients with radiologically confirmed acute ischemic stroke at 24±6 hours post-symptom onset and serum levels of TSH, free T3, and free T4 were measured. Stroke outcomes were measured at discharge, 3 and 12 months using the modified Rankin scale and modified Barthel Index as markers of disability. Though we found that lower levels of free T3 were associated with worse prognosis at hospital discharge, and at 3 and 12 months post-stroke, none of these outcomes held after multivariate analysis. Thus, it is likely that thyroid hormones are associated with other factors that impact stroke outcomes, such as sex, age and stroke etiology.ConclusionsThis study found that lower levels of free T3 were associated with poorer outcomes at hospital discharge, and at 3 and 12 months post stroke, however, these associations diminished after correction for other known predictors of stroke outcome. Thyroid hormones have a complex relationship with ischemic stroke and stroke recovery, which merits further larger investigations.

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Effects of thyroid dysfunction on the severity of coronary artery lesions and its prognosis

Abstract: The patients with hypothyroidism and low T3 syndrome had a high prevalence of CHD, increased severity of coronary artery lesions and poor prognosis.

Cited by 23 publications

References 22 publications

What is the association of hypothyroidism with risks of cardiovascular events and mortality? A meta-analysis of 55 cohort studies involving 1,898,314 participants

What is the association of hypothyroidism with risks of cardiovascular events and mortality? A meta-analysis of 55 cohort studies involving 1,898,314 participants

Association between mild thyroid dysfunction and clinical outcome in acute coronary syndrome undergoing percutaneous coronary intervention

Thyroid hormones and functional outcomes after ischemic stroke

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