The relationship between thyroid stimulating hormone within the reference range and coronary artery disease: impact of age

Yang, Libo; Zou, Jianwen; Zhang, Mingliang; Xu, Hong; Qi, Wenbo; Gao, Ling; Zhao, Jiajun

doi:10.1507/endocrj.ej12-0448

Cited by 8 publications

(6 citation statements)

References 35 publications

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“…This is all due to the sensitivity to catecholamine compounds ( 6 - 8 ). Hypothyroidism instead, seems to evoke a hypoadrenergic state due to the presence of bradycardia, reduced basal metabolism and cardiac output, and the intracellular catecholamine production from circulation, which has been found to be lower during hypothyroidism ( 9 - 11 ).…”

Section: Introductionmentioning

confidence: 99%

Thyroid Hormone Profile in Patients With Acute Coronary Syndrome

Qari

2015

Iran Red Crescent Med J

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Background:Thyroid hormone has the a major role in the cardiovascular system function and cardiac a As well as to maintain the cardiovascular homeostasis A slightly change ind thyroid status actually affects cardiovascular mortality hemodynamic. The background of this study was to define the prevalence of thyroid dysfunction in acute coronary syndrome (ACS).Objectives:The primary objective was to define the prevalence of thyroid dysfunction in acute coronary syndrome, including Non-ST Segment Elevation Myocardial Infarction (NSTEMI), ST-segment Elevation Myocardial Infarction (STEMI), and unstable angina groups. The secondary objective was to determine any associations of thyroids function tests with cardiac catheterization and mortality.Patients and Methods:In a prospective, observational, and cross section study, we enrolled 400 patients admitted at the coronary care unit of King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Venous blood samples were collected from patients for the evaluation of thyroid function (thyroids stimulating hormones, free triiodothyronine, and free thyroxin).Results:Excluding those taking thyroid hormone preparations, 76.7% of patients admitted with acute coronary heart disease (ST-segment elevation myocardial infarction and Non-ST segment elevation myocardial infarction), and unstable angina had euthyroidism. Thyroid dysfunction was reported in 23.3% of patients with coronary heart disease. Overall hypothyroidism prevalence was 7.8%, while subclinical hyperthyroidism in our study was 2.7%. Overt hyperthyroidism and subclinical hyperthyroidism was reported 2.0% and 0.5%, respectively. Euthyroid sick syndrome was noticed in 41 (10.2%) of critically ill patients. The mortality rate was 9.8%; all death patients had low triiodothyronine (T3) syndrome and were associated with statistically significant low free triiodothyronine (FT3) (P > 0.001).Conclusions:No significant variance was observed among patients underwent for cardiac catheterization, STEMI, NSTEMI, unstable angina, and atrial fibrillation with respect to FT4, FT3, and TSH levels during coronary care unit hospitalization based on their profile data.

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Section: Introductionmentioning

confidence: 99%

Thyroid Hormone Profile in Patients With Acute Coronary Syndrome

Qari

2015

Iran Red Crescent Med J

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“…In the current study, we found that thyroid function in the clinically normal range was not associated with CHD and the severity of coronary atherosclerosis. As a contrary, several previous studies of patients undergoing coronary angiography demonstrated that free T 4 or free T 3 level was inversely and TSH concentration was positively associated with the presence of CHD or the severity of coronary atherosclerosis in euthyroid subjects [ 9 – 11 ]. The discrepancy between our study and previous studies can be explained by several aspects.…”

Section: Discussionmentioning

confidence: 93%

“…Results of some cross-sectional studies of patients undergoing coronary angiography suggested that free thyroxine (T 4 ) or free triiodothyronine (T 3 ) level was inversely and thyroid stimulating hormone (TSH) concentration was positively associated with the presence of CHD or the severity of coronary atherosclerosis in euthyroid subjects [ 9 – 11 ]. By contrast, one study reported that free T 3 level was positively associated with the presence and severity of CHD [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Thyroid Function, Prevalent Coronary Heart Disease, and Severity of Coronary Atherosclerosis in Patients Undergoing Coronary Angiography

Ling

Jiang

Gui

et al. 2015

International Journal of Endocrinology

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This study investigated if free T4 and TSH concentrations or thyroid function categories were associated with prevalent CHD and the severity of coronary atherosclerosis in a population undergoing coronary angiography. This was a cross-sectional study including 1799 patients who were consecutively admitted and underwent coronary angiography. We evaluated the severity of coronary atherosclerosis using Gensini score. In the entire study population, free T4 level was inversely associated with prevalent CHD (OR = 0.95, 95% CI 0.91–0.99, P = 0.01) and the natural log-transformed Gensini score (ln(Gensini score)) (β = −0.03, 95% CI −0.05–−0.01, P = 0.005). The odds of CHD increased gradually across hyperthyroidism, subclinical hypothyroidism, and overt hypothyroidism groups using the euthyroid group as the reference, and the trend is borderline significant (P for trend = 0.051). When comparing to the euthyroid group, ln(Gensini score) of the overt hypothyroidism group was significantly higher (P = 0.009), but the trend was not significant (P for trend = 0.08). A significant association of thyroid function with CHD or ln(Gensini score) in euthyroid patients was not observed. The present study demonstrated an association of thyroid function with prevalent CHD and the severity of coronary atherosclerosis in a population undergoing coronary angiography. However, this association was not observed in euthyroid individuals.

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“…Hyland KA et al revealed that risk of CVD, heart failure, and cardiovascular death did not increase in older adults with persistent subclinical hypothyroidism [36]. However, some studies showed that the association between subclinical hypothyroidism and CVD was strong [37] or only existed [38] among individuals ≤65 yeas old. Treatment of subclinical hypothyroidism with levothyroxine provided no apparent benefits in older adults [39].…”

Section: Discussionmentioning

confidence: 99%

Age-related change in thyroid-stimulating hormone: a cross-sectional study in healthy euthyroid population

et al. 2018

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This cross-sectional study aimed to examine changes in thyroid-stimulating hormone (TSH) concentration over age in China and investigate relationship between TSH and risk factors for cardiovascular disease (CVD) among euthyroid subjects. TSH, free triiodothyronine (FT3), free thyroxine (FT4), blood lipid, and glucose were measured. 7,693 individuals were subdivided into different age groups. Associations between TSH and CVD risk factors [age, body mass index (BMI), systolic and diastolic blood pressure, total cholesterol (TC), triglycerides, low density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) and fasting plasma glucose (FPG)] were evaluated with Pearson correlation analysis. Results showed that 2.5th percentile for TSH was consistent across age groups, whereas 97.5th percentile increased in subjects older than 40 years with upper limit being 6.83 mIU/L in subjects aged 60-69 years and 8.07 mIU/L in those older than 70 years. The age-speciﬁc upper limits reclassiﬁcation rate was higher in all age bands as compared to the common cut-off value. TSH was positively associated with age, SBP, DBP, TC and LDL-C and negatively with FT3 and FT4. Serum TSH within new reference range had a linear correlation with SBP, TC and LDL-C in subjects aged <60 years. There were no significant differences in BMI, blood pressure, lipid profile or FPG among subjects 60-69 and older than or equal to 70 years. Elevated TSH within new reference range is associated with risk factors for CVD in subjects aged <60 years. Thus, there might be age-related difference in the relationship between CVD risk factors and elevated serum TSH.

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The relationship between thyroid stimulating hormone within the reference range and coronary artery disease: impact of age

Cited by 8 publications

References 35 publications

Thyroid Hormone Profile in Patients With Acute Coronary Syndrome

Thyroid Hormone Profile in Patients With Acute Coronary Syndrome

Thyroid Function, Prevalent Coronary Heart Disease, and Severity of Coronary Atherosclerosis in Patients Undergoing Coronary Angiography

Age-related change in thyroid-stimulating hormone: a cross-sectional study in healthy euthyroid population

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