Subclinical Hypothyroidism with TSH&gt;7 mIU/l and≤10 mIU/l and Coronary Artery Disease

Rosário, Pedro Weslley; Calsolari, Maria Regina

doi:10.1055/a-1083-6509

Cited by 9 publications

(9 citation statements)

References 22 publications

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“…The cardiovascular system is a classic target tissue for thyroid hormones [4][5][6]. Overt hyperthyroidism causes an increase in RHR, with free triiodothyronine (FT3) rather than free thyroxine (FT4) being considered the main driver for the complex cardiac effects of thyroid hormones [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Overt hyperthyroidism causes an increase in RHR, with free triiodothyronine (FT3) rather than free thyroxine (FT4) being considered the main driver for the complex cardiac effects of thyroid hormones [4,5]. However, there still exist huge knowledge gaps regarding the clinical relevance of cardiovascular effects of subclinical thyroid dysfunctions or thyroid hormones within the normal range [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Associations of Thyroid Hormones and Resting Heart Rate in Patients Referred to Coronary Angiography

et al. 2020

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Resting heart rate (RHR) is associated with increased risk of cardiovascular morbidity and mortality. Thyroid hormones exert several effects on the cardiovascular system, but the relation between thyroid function and RHR remains to be further established. We evaluated whether measures of thyroid hormone status are associated with RHR in patients referred to coronary angiography. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxin (FT4), and RHR were determined in 2795 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study. Median (25th to 75th percentile) serum concentrations were 1.25 (0.76–1.92) mU/l for TSH, 4.8 (4.2–5.3) pmol/l for FT3 and 17.1 (15.4-19.0) pmol/l for FT4, and mean (±standard deviation) RHR was 68.8 (±11.7) beats/min. Comparing the highest versus the lowest quartile, RHR (beats/min) was significantly higher in the fourth FT4 quartile [3.48, 95% confidence interval (CI): 2.23–4.73; p <0.001] and in the fourth FT3 quartile (2.30, 95% CI: 1.06–3.55; p <0.001), but there was no significant difference for TSH quartiles. In multiple linear regression analyses adjusting for various potential confounders, FT3 and FT4 were significant predictors of RHR (p <0.001 for both). In subgroups restricted to TSH, FT3, and FT4 values within the reference range, both FT3 and FT4 remained significant predictors of RHR (p <0.001 for all). In conclusion, in patients referred to coronary angiography, FT3 and FT4 but not TSH were positively associated with RHR. The relationship between free thyroid hormones and RHR warrants further investigations regarding its diagnostic and therapeutic implications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations of Thyroid Hormones and Resting Heart Rate in Patients Referred to Coronary Angiography

et al. 2020

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“…SCH was de ned in accordance with The Endocrine Society diagnosis, as the serum TSH≥4.5mU/L and FT4 within the normal range [11]. The grades of SCH were categorized as mild SCH when TSH level 4.5-7 mU/L, moderate SCH when TSH level 7-10 mU/L and severe SCH when TSH≥10 mU/L [4,12,13]. Included patients were further subdivided into different degree of SCH groups (mild SCH vs moderate SCH vs. severe SCH: 143 vs 62 vs 28) and different gender groups (men with SCH vs. women with SCH:116 vs 118).…”

Section: Study Populationmentioning

confidence: 99%

Characteristics of Coronary Artery Disease in Patients with Subclinical Hypothyroidism: Evaluation Using Coronary Artery Computed Tomography Angiography

Zhou

Shi

Wang

et al. 2021

Preprint

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Background: Subclinical hypothyroidism (SCH) has recently been acknowledged as an independent risk factor for coronary artery disease (CAD). However, the characteristics of CAD in patients with SCH are not fully understood. This study aims to evaluate the features of CAD in patients with SCH using coronary computed tomographic angiography (CCTA).Materials and Methods: From 1 April, 2018 to 30 June, 2020, 234 consecutive SCH patients with coronary plaques identified on CCTA were included retrospectively. They were further subdivided into different degree of SCH groups (mild SCH vs. moderate SCH vs. severe SCH: 143 vs 62 vs 28) and different gender groups (men with SCH vs. women with SCH:116 vs 118). The distributions and types of plaques, luminal narrowing, segment involvement scores (SIS) and segment stenosis scores (SSS) were evaluated and compared among the different groups.Results: Patients with severe SCH had fewer calcified plaques (0.7 ± 0.9 vs. 2.0 ± 1.9, p < 0.001) and more non-calcified plaques (0.9 ± 1.0 vs. 0.3 ± 0.5, p < 0.001) than those with mild SCH. As the SCH condition worsened, the proportion of non-calcified plaques significantly increased. Whereas there were no significant discrepancies in SIS and SSS among patients with different grades of SCH (all p > 0.05). Men with SCH had higher SIS (3.9 ± 2.3 vs. 3.0 ± 2.3, p = 0.004) and SSS (7.8 ± 5.4 vs. 5.4 ± 3.0, p = 0.002) than women. Multivariate logistic and linear regression analysis demonstrated that grades of SCH (Moderate SCH, odds ratio [OR]: 2.11; 95% CI 1.03–4.34, p = 0.042; severe SCH, OR: 10.00; 95% CI 3.82–26.20, p < 0.001, taken mild SCH as a reference) was independently associated with the presence of non-calcified plaques, whereas sex (B: 1.67; 95% CI 0.27–3.10, p = 0.009) was independently associated with SSS. Conclusions: Severe SCH is associated with non-calcified plaques, and men with SCH have higher total plaque burden than women. We suggest that it is important to evaluate for coronary plaque in SCH patients, especially those with severe SCH and men with SCH.

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“…Subclinical hypothyroidism and clinical hypothyroidism, two commonly encountered clinical conditions, can induce various metabolic changes ( 1 ) and increase the risk of cardiovascular diseases ( 2 , 3 ). Recent researches have shown that both subclinical hypothyroidism and hypothyroidism were associated with elevated serum creatinine, decreased estimated glomerular filtration rate (eGFR) and increased risk of chronic kidney disease (CKD) ( 4 , 5 , 6 , 7 ). Moreover, the recent evidence from a mendelian randomization study demonstrated a directional association from hypothyroidism to decreased eGFR and increased CKD ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Relation of kidney function and homocysteine in patients with hypothyroidism

Qin

Gao

et al. 2021

Endocrine Connections

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Objective: It has been found that both serum homocysteine (Hcy) and serum creatinine levels were increased in hypothyroidism patients. The aim of this study was to investigate the correlation between serum Hcy and kidney function in patients with subclinical hypothyroidism or hypothyroidism. Methods: A total of 448 subjects were enrolled and divided into three groups: hypothyroidism (n=129), subclinical hypothyroidism (n=141), and control group (n=168). Anthropometric information, metabolic parameters, serum Hcy and creatinine levels, and estimated glomerular filtration rate (eGFR) were analyzed. Results: Compared with healthy subjects, patients with subclinical hypothyroidism or hypothyroidism had significantly higher serum Hcy and creatinine levels and lower eGFR level (all P<0.001). Serum Hcy was negatively correlated with eGFR in subclinical hypothyroidism patients (r =-0.220, P=0.009), and in hypothyroidism patients (r =-0.422, P<0.001). After adjusting for age, sex and body mass index, eGFR was still significantly correlated with serum Hcy in subclinical hypothyroidism or hypothyroidism patients (both P<0.05). Levothyroxine treatment resulted in significantly decreased Hcy and increased eGFR in hypothyroidism patients (both P<0.001). The decrease in Hcy was correlated with the increased eGFR after treatment (P=0.001). Conclusion: Serum Hcy was negatively correlated with eGFR in subclinical hypothyroidism or hypothyroidism patients. After levothyroxine treatment, a correlation was found between the decrease in serum Hcy and the increase in eGFR in hypothyroidism patients.

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Subclinical Hypothyroidism with TSH>7 mIU/l and≤10 mIU/l and Coronary Artery Disease

Cited by 9 publications

References 22 publications

Associations of Thyroid Hormones and Resting Heart Rate in Patients Referred to Coronary Angiography

Associations of Thyroid Hormones and Resting Heart Rate in Patients Referred to Coronary Angiography

Characteristics of Coronary Artery Disease in Patients with Subclinical Hypothyroidism: Evaluation Using Coronary Artery Computed Tomography Angiography

Relation of kidney function and homocysteine in patients with hypothyroidism

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