The Impact Of Thyriod Hormones On The Prognosis Of Coronary Heart Disease Patients With Subclinical Hypothyroidism In SYNTAX? System

Objective:To investigate the effect of subclinical hypothyroidism(SCH)on biochemical indexes of coronary artery disease(CAD)(such as hypertension,diabetes and left ventricular ejection fraction).To determine whether subclinical hypothyroidism impact the severity and the prognosis of CAD patients according to the SYNTAXII score.Methods:This is a retrospective study,541 patients(388 men,153women)who had been diagnosed of coronary heart disease by coronary angiography examination were recruited between January 2015 and January 2016 at the department of cardiology in Dalian Medical University.They were divided into three groups according to their thyroid function.They are subclinical hypothyroidism group(65 patients),clinical hypothyroidism group(30patients),hyperthyroidism group(17 patients),low FT3 syndrome group(83 patients)and normal thyroid function group(368 patients).Coronary artery lesion severity was evaluated by SYNTAXI score,which was divided into three groups:SYNTAXI<8(n=166),8?SYNTAXI<12(n=190)and 12<SYNTAXI<21(n=185);SYNTAXII score was also divided into three groups:SYNTAXII<22(n=185),22<SYNTAXII<29(n=163)and SYNTAXII?29(n=193).Subclinical hypothyroidism patients were divided into group A(49 patients,10 mu IU/mL>TSH>4.00 mu IU/mL),group B(13 patients,TSH>10 mu IU/mL)and control group C(365 patients whose FT3,FT4,and TSH were normal).MACE(major adverse cardiovascular events)were recorded for a follow-up period of 20 months.We evaluated the association between thyroid hormone concentrations and MACE events according to the SYNTAXII score.Results:High TSH(TSH>10 mu IU/mL)was significant predictor of MACE events in female CHD patients who were prone to have higher TG and hypertension level.While TSH showed no consistent correlation with SYNTAXII score.The TSH has no significant correlation with lesion counts and SYNTAXI score.SYNTAXI score,TSH and SYNTAXII score were significant predictors of short-term MACE events(n?20 months).Subclinical hypothyroidism had no effect on short-term MACE events(n?20 months)and cannot accelerate the process of coronary heart disease(CHD).Conclusion:High TSH concentrations are significantly related to MACE events,but has nothing to do with the severity of coronary lesions.These findings suggest that TSH should be measured and considered as an independent predicting factors in patients with coronary heart disease(CHD).