Association of serum thyrotropin levels with coronary artery disease documented by quantitative coronary angiography: a transversal study

Abstract

Objective: The association between coronary artery disease (CAD) and thyroid function remains controversial. We evaluated the thyroid function and graduated well-defined CAD as confirmed by quantitative coronary angiography (CA). Subjects and methods: We evaluated the serum TSH, free thyroxine, free triiodothyronine and thyroid antibody levels in 300 consecutive patients (age 61.6 ± 9.9 years and 54% were male) undergoing CAD diagnosis as confirmed by CA. Plaques with ≥ 50% stenosis being indicative of obstructive CAD, and patients were divided into groups according to main epicardial coronary arteries with plaques (0, 1, 2, 3). Lipid profiles and a homeostasis model assessment (HOMA-IR) were determined. Results: Serum median (25% and 75% percentile) TSH levels in patients with group 2 and 3 (2.25; 1.66-3.12 mU/L and 4.99; 4.38-23.60 mU/L, respectively) had significantly higher TSH concentrations (p < 0.0001) than the group 0 (1.82; 1.35-2.51 mU/L). Furthermore, patients of group 3 had higher TSH concentration (p < 0.0001) than those of group 1 (1.60; 0.89-2.68 mU/L). Group 3 were older (64 ± 8.5 vs. 59 ± 9.5, p = 0.001), had more patients with dyslipidemia (84% versus 58%, p < 0.001), male (54% versus 44%, p = 0.01), hypertension (100% versus 86%, p < 0.001), and smoking (61% versus 33%, p < 0.001) than group 0. Multivariate stepwise logistic analysis showed TSH, age, HbA1c, and HOMA-IR were the CAD associated variables. Conclusions: In this cohort, elevated TSH levels in the high normal range or above are associated with the presence and severity of CAD besides may represent a weak CAD risk factor.

The Effect of Increased Iodine Intake on Serum Thyrotropin: A Cross-Sectional, Chinese Nationwide Study

“…Subclinical hypothyroidism is significantly associated with dyslipidemia and cardiovascular disease (CVD) and has been one of the hot topics in thyroid and cardiovascular sciences (5). Furthermore, specific clinical symptoms of subclinical hypothyroidism are lacking, and the diagnosis of the condition is mainly dependent on laboratory tests, that is, elevated serum TSH and normal serum thyroxine concentrations (6).…”

The Prognostic Value of Thyroid-Stimulating Hormone in Patients with Coronary Artery Disease and Depression

“…Serum TSH was also proved to increase inflammatory molecules and inhibit nitric oxide production. 12 , 30 The increased inflammatory reaction will accelerate the atherosclerosis process and inhibit endothelial cell functions, such as migration and angiogenesis. 29 , 31 What is more, chronic low-grade inflammation was believed to be one important pathogenesis of depression.…”