| Objective:(1)To analyze the clinical characteristics of patients with coronary heart disease complicated with subclinical hypothyroidism.(2)To investigate the relationship between TSH level and coronary lesion.Methods:In this study,291 patients who were diagnosed as coronary heart disease by coronary angiography(CAG)and finished thyroid function examination and meet the inclusion and exclusion criteria and have complete data from December 2016 to April 2019 in the Department of Cardiology,First Affiliated Hospital of Medical College of Shihezi University were collected.Among them,92 patients with coronary heart disease complicated with subclinical hypothyroidism were taken as the case group and 199 patients with normal thyroid function of coronary heart disease were taken as the control group.The general clinical data of patients,serum thyroid stimulating hormone(TSH),free thyroxine(FT4),free triiodothyronine(FT3),blood lipid index,fibrinogen,blood glucose and cardiac color Doppler ultrasound results were collected,coronary angiography results were recorded,and Gensini score and lesion number were counted.(1)Subgroup analysis was carried out in different genders.Among them,43 cases with subclinical hypothyroidism and 134 cases with normal hypothyroidism were found in males.Among the women,49 cases had subclinical hypothyroidism and 65 cases had normal hypothyroidism.The differences of clinical data between the groups were compared respectively.(2)Divided into single-vessel lesion group(94 cases)and multi-vessel lesion group(197 cases)according to the number of coronary artery lesions,and compared the difference of each index between the two groups.Results:(1)The proportion of male patients in coronary heart disease combined with subclinical hypothyroidism group is lower than that in the control group,and their age is higher than that in the control group.the difference is statistically significant(P<0.05).there is no statistical difference between the two groups in other aspects.(2)Among men,TG and Gensini score of coronary heart disease combined with subclinical hypothyroidism group were higher than those of control group,the difference was statistically significant(P<0.05),and there was no statistical difference between the two groups in other aspects.(3)Among women,LDL-C,apo-B and coronary Gensini scores of coronary heart disease combined with subclinical hypothyroidism group were higher than those of control group,while EF values of coronary heart disease combined with subclinical hypothyroidism group were lower than those of control group,with statistically significant difference(P<0.05).there was no statistical difference between the two groups in other aspects.(4)Spearman correlation analysis showed that TSH was positively correlated with coronary Gensini score(r=0.141,P<0.05),while FT3 and FT4 were negatively correlated with coronary Gensini score(r=-0.123,r=-0.165)(P<0.05).(5)After grouping according to the quartile of TSH,it was found that the coronary Gensini score in group D(TSH≥4.75mIU/L)was significantly higher than that in group a(TSH<1.73mIU/L),group B(1.73mIU/L≤TSH<2.88mIU/L)and group C(2.88mIU/L≤TSH<4.75mIU/L),the difference was statistically significant(P<0.05),while there was no statistical difference among theother three groups(P>0.05).(6)Univariate Logistic regression analysis of coronary artery Gensini score showed that male and subclinical hypothyroidism were risk factors for high coronary artery Gensini score(P<0.05),while apo-A was protective factor for high coronary artery Gensini score(P<0.05).(7)Logistic regression model was established by taking coronary Gensini score as dependent variable.the results showed that subclinical hypothyroidism was still the independent risk factor for high Gensini score after correcting related risk factors for many times(P<0.05).(8)Compared with the group with single coronary artery lesion,the group with multiple coronary artery lesions has a higher proportion of males and diabetes mellitus,and higher TSH and FBG levels,while the levels of FT4,HDL-C and apo-A are lower,with statistical significance(P<0.05),while there is no statistical difference in FT3 comparison between the two groups(P>0.05).(9)Logistic regression analysis showed that TSH was an independent risk factor for coronary artery disease(P<0.05).Conclusion:(1)The blood lipid level of patients with coronary heart disease complicated with subclinical hypothyroidism is higher than that of patients with normal coronary heart disease hypothyroidism.Among them,males mainly show higher triglyceride,while females mainly show higher low density lipoprotein.(2)Serum TSH is positively correlated with coronary Gensini score,which is a risk factor for multiple coronary artery lesions. |
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