Correlation Between Thyroid Hormone Levels And The Degree Of Coronary Artery Stenosis In Postmenopausal Women With ACS

Background and objective:Menopause is a natural aging process of estrogen deficiency.In this period,Women lose the protective effect of estrogen on endothelial cells of vascular,which end up with hyperlipidemia and accelerating the progression of atherosclerosis that cause women more susceptible to cardiovascular disease and stroke.In recent years,the female patients with coronary heart disease in the Department of cardiology rapidly increasing than before,especially postmenopausal women,and suffer more severe health complications than male patients.They also found almost no difference between incidence of coronary heart disease in male and female in the 10 years after menopause.Over time,female develop coronary heart disease sightly more often than male after 10 years of menopause.Despite delayed of onset time,female suffer a worse mortality and severity of coronary heart disease.Now,cause the research on new risk factors is still limited,we can only prevent the occurrence of cardiovascular disease from the traditional risk factors,new types of risk factors are constantly being proposed,but there is still a lack of reliable evidence.As the survival period become longer,people ask for higher expectations of life quality.It’s more important to refined primary prevention and secondary prevention of diease,and it is pointed out that atherosclerotic disease will underlyinng atherosclerotic process before clinical symptoms.Therefore,it’s more important to strengthen screening and assessment of the risk factors of cardiovascular disease.Reachers around the globe shows that prevalence rate of thyroid disorder in postmenopausal women rise suddenly compared the premenopausal,corresponding data shows that serum TSH level is closely related to estrogen,with the decline of the estrogen,serum TSH level has a significant tendency of rising,Serum TSH level has a close connection with lipid metabolism and vascular endothelium function,which takes a part in the progression of AS.Epidemiology statistics shows that incidence and death rate of cardiovascular disease and stroke in postmenopausal women present a significant tendency of rising.Often,trace amount of FT3,FT4 acts extensively,slowly and persistently in body,the combination of FT3,FT4 with receptors of target cells produces important physiological effects and the effectivly reflection that change of the hormone density related to the physiological and pathological condition of the body makes it a great indicator of assessing the patient’s condition.While studies in the past have shown that SCH are interlocked with AS.Whether the serum thyroid hormone levels within normal range are associated with AS or not is still unclear.Therefore,we try to clear up how the thyroid stimulating hormone changes in different gender and age,and further demonstrating the relationship between serum of thyroid hormones levels within normal range and severity of CAS in postmenopausal women with ACS who have normal thyroid function,providing a new reference index about health management for elderly female patients.Method:We performed a retrospective review of four hundred and fine patients who visited cardiovascular medicine department and underwent coronary arteriography(CAG)from September,2015 to October,2017.All patients have normal thyroid function and assessed by GE inova 2000 angiography machine.Patients divided into ACS group and control group based on the results of CAG.Postmenopausal women(n=247)with ACS as group A.The patients in non-ACS group includes unmenopausal women(n=30)as group B,elderly man(n=30)as group C.postmenopausal women(n=98)as group D.Group A is the experimental group and the other is control group.According to their results of CAG.The severity coronary artery stenosis of ACS group was assessed by Gensini score.Correlation between thyroid hormone levels and the degree of coronary artery lesions in postmenopausal women with ACS were evaluated by both single factors analysis and multivariate binary logistic regression analysis.Results:1The serum TSH levels within normal range was significantly higher in postmenopausal women than that in unmenopausal women and men in the same age(P<0.05).2Compared with the non-ACS group,the single factors analysis revealed that the postmenopausal women with ACS were older(P <0.05),and with higher incidence of hypertension,higher levels of TG and LDL-C(P < 0.05),and lower levels of FT3(3.88±0.68,4.09±0.64,P<0.05).3Binary logistic regression analysis revealed that low FT3 level was closely associated with the severity of coronary artery stenosis in postmen-opausal women with ACS(OR=0.619,95%CI:0.424-0.905,P=0.013).Conclusions:The serum of TSH levels in postmenopausal women was significantly higher than unmenopausal women and men of the same age.The serum of low FT3 levels within normal range was closely associated with the severity of coronary artery stenosis in postmenopausal women with ACS.