Thyroid Dysfunction in Patients Admitted in Cardiac Care Unit: Prevalence, Characteristic and Hospitalization Outcomes

Abstract

Introduction Cardiovascular disease is one of the main causes of hospital admission and mortality, and thyroid dysfunction increases the risk of developing acute or exacerbation of chronic cardiac conditions. The aim of this study is to investigate the prevalence of thyroid hormone abnormality among patients in the cardiac care unit (CCU) patients and its relation to admission diagnosis, clinical, biochemical data, and hospital-related outcomes. Methods We conducted a retrospective cohort observational that included adult patients who were admitted to the CCU. We excluded those with known thyroid dysfunction and those who received amiodarone or IV contrast. Results A total of 374 patients with a mean age of 62.7+14.7 years old were included. Ischemic changes were observed in 70.6% of the patients based on the admission diagnosis. In comparison to the non-ischemic group, the ischemic group was more likely to be male (P=0.010), to be active/former smokers (P=0.011), to have diabetes (P=0.009), to have diastolic dysfunction (P=<0.001), to have undergone thrombolysis (P=<0.001), and to have been referred to a tertiary center (P=<0.001). Euthyroidism was observed in 57.8% of the patients based on the thyroid function test at admission. Compared to patients with thyroid dysfunction, those with Euthyroidism were more likely to be active/former smokers (P=0.002), to have lower heart rates (P=0.018), to not have chronic kidney disease (P=0.016), to not have heart failure (P=0.006), to have lower thyroid-stimulating hormone (TSH) levels (P=<0.001), and to have lower tricuspid regurgitation (P=0.042). Conclusion Thyroid dysfunction is common among patients admitted to the CCU. Non-significant positive correlations between TSH and hospitalization length, tertiary center referral, 30-day readmission, and in-hospital mortality when adjusting for potential confounders.

State of Thyroid Gland Function in Patients Admitted to Coronary Care Unit

“…Furthermore, the frequency of smokers within the study was lower than non-smokers. However, on the contrary, in a study whose smoker participants are higher than non-smokers (3) , another study found fewer smoker rates like ours (14) . Regarding the presence of chronic diseases, hypertension, diabetes mellitus, and dyslipidemia were the most common comorbid conditions as in other studies too (15,17) .…”

“…The most common causes of admission in our study were acute coronary syndrome and arrhythmia, but in other studies, the most common causes were acute coronary syndrome and decompensated heart failure (14) .…”

“…In other published studies, the mean free T4 was lower, meaning TSH was higher than ours among ACS patients. At the same time, the mean LDL was lower among patients with coronary artery diseases than the mean LDL of our study (3,14) . Regarding arrhythmia patients, the study was found to lower mean free T4 and lower mean TSH than our findings (17) .…”

“…In our study, we tried to discover thyroid gland function abnormalities in patients admitted to CCU, searching for the prevalence of different thyroid gland functions that could lead to different cardiac conditions. In the study, male participants were more than females gender as recent studies show a higher number of male patients (13,14) , and another study shows higher female participants (16) . Furthermore, the frequency of smokers within the study was lower than non-smokers.…”

Hypothyroidism and the risk of coronary artery disease in Saudi patients

“…One local study concluded that there was no significant association between hypothyroidism and CAD. [ 10 ]…”