Effect Of Iodine Contrast Media On Thyroid Function And Prognosis In Patients With Coronary Heart Disease

Research purposes:To analyse the effect of iodine contrast media on thyroid function in patients with coronary atherosclerotic heart disease,and to analyze the metabolic and cardiac function,so as to provide the basis for the rational application of iodine contrast media.Research methods:This study was a retrospective study.The informa-tion of 146 patients who underwent CAG and PCI in the Department of Cardiology of our hospital from January 2019 to December 2020 were collected.Record demographic data（age and gender）,the frequency of CAG and PCI,iodine contrast media related conditions（name and dose）,thyroid disease history,FT₃,FT₄,TSH,TC,TG,LDL-C,HDL-C,blood glucose,pro-BNP,LVDM,EF.Research results:1.In patients with coronary heart disease with normal thyroid func-tion（n=116）,6.0%（7/116）patients developed subclinical hypothyroidism after exposure to iodine contrast media,which is the most.0.9%（1/116）developed hyperthyroidism,and 2.6%（3/116）developed Euthyroid sick syndrome.FT₃and TSH increased after exposure to iodine contrast media compared with before exposure（P<0.05）,but FT₄had no significant cha-nge（P>0.05）.2.FT₃ and TSH of coronary heart disease patients with normal thyroid function under 65 years old（n=74）increased（P<0.05）,but FT₄had no significant change（P>0.05）after using iodine contrast media.There was no significant change of thyroid hormone in patients with cor-onary heart disease with normal thyroid function（n=42）older than 65years（P>0.05）.3.In patients with coronary heart disease with normal thyroid funct-ion（n=116）,FT₃increased in patients with coronary heart disease within6 months（n=28）（P<0.05）,but FT₄and TSH had no significant changes（P>0.05）after using iodine contrast media.FT₃and TSH in patients with coronary heart disease within 7-11 months（n=39）increased（P<0.05）,but FT₄had no significant change（P>0.05）after the use of iodine contrast media.FT₄increased in patients with coronary heart disease（n=49）for more than 1 year（P<0.05）,but FT₃and TSH had no significant changes（P>0.05）after the use of iodine contrast media.4.In patients with coronary heart disease with normal thyroid func-tion（n=116）,the levels of TC,TG and LDL-C in blood decreased（P<0.05）and the level of HDL-C in blood increased（P<0.05）after using iodine contrast media compared with before,and blood glucose had no significant changes（P>0.05）.5.In patients with coronary heart disease with normal thyroid func-tion（n=116）,there were no significant changes in pro-BNP,LVDM and EF after the use of iodine contrast media compared with before the use of iodine contrast media（P>0.05）.6.Coronary heart disease patients with abnormal thyroid function（n=30）,after exposure to iodine contrast media,46.7%（7/15）remained subclinical hypothyroidism,53.3%（8/15）of patients with subclinical hy-pothyroidism with coronary atherosclerotic heart disease（n=15）returned to normal.FT₃increased and TSH decreased after exposure to iodine con-trast media（P<0.05）.And FT₄had no significant changes.20%（1/5）developed hyperthyroidism and 80%（4/5）thyroid function returned to normal.After ESS patients with coronary heart disease（n=10）were treat-ed with iodine contrast media,10%（1/10）remained ESS,90%（9/10）ret-urned to normal.7.In patients with coronary heart disease with thyroid dysfunction（n=30）,patients with subclinical hypothyroidism（n=15）,the levels of TC and LDL-C in blood decreased after using iodine contrast media comp-ared with before using iodine contrast media（P<0.05）,while the levels of TG,HDL-C and blood glucose had no significant changes（P>0.05）.8.In patients with coronary heart disease with thyroid dysfunction（n=30）,patients with subclinical hypothyroidism（n=15）,there were no si-gnificant changes in pro-BNP,LVDM and EF after the use of iodine contrast media compared with before the use of iodine contrast media（P>0.05）.Research conclusions:1.Coronary heart disease patients with normal thyroid function ma-inly have subclinical hypothyroidism after exposure to iodine contrast media,accounting for 6.0%.FT₃ and TSH increased within 1 year after the use of iodine contrast media,and FT₄increased more than 1 year,but FT₃and TSH had no significant changes.Thyroid hormone changes were obvious in patients with normal thyroid function under 65 years old,but no significant changes in patients with normal thyroid function over 65years old.2.Patients with coronary heart disease with thyroid dysfunction,whether it is subclinical hypothyroidism,subclinical hyperthyroidism or ESS,the thyroid function gradually returns to normal over time after the use of iodine contrast media.3.In patients with coronary heart disease with subclinical hypothy-roidism,TC and LDL-C decreased after using iodine contrast media,wh-ile blood glucose and cardiac function showed no significant changes.