Prevalence of Subclinical Hypothyroidism in Acute Coronary Syndrome in Nondiabetics: Detailed Analysis from Consecutive 1100 Patients from Eastern India

Abstract

Background The association between subclinical thyroid dysfunction (defined by no symptoms or clinical features of hypothyroidism but biochemically TSH level in the range of above 5 miu/ml but below 10 miu/ml with normal FT4 level) and Acute Coronary Syndrome (ACS) is not known so far. This study was done to calculate the prevalence of subclinical thyroid dysfunction in patients with ACS. Methods A retrospective chart review of 1100 consecutive patients was done who presented to Emergency Department with symptoms suggestive of ACS and admitted. They were later classified in 3 categories that includes Acute ST Elevated Myocardial Infarction (STEMI), Unstable Angina (UA), and Acute Non-ST Elevated Myocardial Infarction (NSTEMI). Thyroid function test (FT4, TSH) and antithyroid peroxidase (TPO) were done and evaluated properly. Results Of 1100 consecutive patients 168 (15.27%) patients had the biochemical features of subclinical thyroid dysfunction. These 168 patients include 60 STEMI, 66 NSTEMI, and 42 Unstable Angina patients. There were no statistically significant differences in terms of left ventricular ejection fraction (LVEF) and catheterisation results considering thyroid dysfunction. Conclusions Subclinical thyroid dysfunction is quite prevalent in ACS patients. There are no significant associations between STEMI, Unstable Angina, or NSTEMI patients in terms of thyroid dysfunction neither in single vessel versus multivessel disease involvement. The causative role and outcomes of treatment are still uncertain and need further follow-up.

Unknown Subclinical Hypothyroidism and In-Hospital Outcomes and Short- and Long-Term All-Cause Mortality among ST Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

“…In contrast to those findings and to the present ones, a recent study of heart failure patients found that LVEF did not differ between those with SCH and those who were euthyroid [18]. Moreover, the LVEF did not differ by thyroid fraction among individuals with acute coronary syndrome in another report [34].…”

A clinico-epidemiological analysis of subclinical hypothyroidism in a tertiary care health center

“…This is important, as screening that focuses on vulnerable population is likely to detect disease more frequently and timely intervention will reduce the chances of overt disease. 17 Prevalence in females was double as compared to males in the present study, which is in corroboration to findings of other studies. 5,17,18 Subclinical hypothyroidism has numerous complications on female fertility, maternal and fetal outcomes in pregnancy.…”

“…17 Prevalence in females was double as compared to males in the present study, which is in corroboration to findings of other studies. 5,17,18 Subclinical hypothyroidism has numerous complications on female fertility, maternal and fetal outcomes in pregnancy. It has been cited in many studies that incidence of subclinical hypothyroidism escalates with advancing age.…”

Prognostic implications of thyroid hormone alterations in acute coronary syndrome–A systematic review

“… 14 These consequences are very important for the onset of ACS where parts of myocardium functionality is impaired due to ischaemia related injury. 15 Since all cardiovascular abnormalities are reversed restoration of euthyroidism (“subclinical hypothyroidism”) should be the goal. The clinical features of hyperthyroidism can be blunted by using beta adrenergic or drugs like neo mercazole.…”

“… Helmy et al. 15 2016 Prospective ACS 300 At admission 1 year Prevalence of subclinical hypothyroidism is 5% in ACS patients. Lymvaios et al.…”