Association of Baseline Thyroid Stimulating Hormone With In-Hospital Outcomes in Patients With Atrial Fibrillation and Coronary Artery Diseases.

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Practice Pub Date : 2024-12-25 DOI:10.1016/j.eprac.2024.12.015

Lisha Zhang, Yan Zhang, Fuxue Deng, Wei Jiang

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Abstract

Objective: Thyroid stimulating hormone (TSH) is related to increased atrial fibrillation (AF) inducibility and plays an important role in a variety of cardiovascular diseases. However, the association of baseline TSH with in-hospital outcomes in patients with AF and coronary artery disease (CAD) is unknown. This study aimed to investigate the distribution of baseline TSH and its association with in-hospital outcomes (major adverse cardiovascular events, all-cause death, or heart failure [HF]) in AF patients combined with CAD.

Methods: A total of 19 725 patients with AF were included. The status of blood TSH was investigated. Patients with AF and CAD were divided into low, median, and high-TSH subgroups based on tertiles of baseline TSH levels. Clinical characteristics and in-hospital outcomes were compared. Logistic regression analysis was performed to determine the association of TSH with in-hospital outcomes. Subgroup analysis was also performed.

Results: In patients with AF and CAD, compared with the low-TSH group, the median-TSH (OR 0.277, 95% CI 0.078-0.991, P = .048) and high-TSH (OR 0.163, 95% CI 0.036-0.750, P = .020) groups were associated with decreased all-cause death. Besides, high TSH showed a protective role for HF events, and the same results were seen in females, age ≥75, and non-non-hypertension subgroups.

Conclusion: Higher baseline TSH presented a protective effect on in-hospital all-cause death and HF in patients with AF combined with CAD.

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基线促甲状腺激素与房颤和冠状动脉疾病患者住院预后的关系

目的：促甲状腺激素（TSH）与心房颤动（AF）诱发性增高有关，在多种心血管疾病中发挥重要作用。然而，基线TSH与房颤合并冠心病（CAD）患者住院预后的关系尚不清楚。本研究旨在探讨AF合并CAD患者的基线TSH分布及其与住院结局（主要不良心血管事件[MACE]、全因死亡或心力衰竭[HF]）的关系。方法：共纳入19725例房颤患者。观察血TSH水平。根据基线TSH水平的分位数，将AF和CAD患者分为低、中、高TSH亚组。比较临床特征和住院结果。采用Logistic回归分析确定TSH与住院预后的关系。并进行亚组分析。结果：在AF和CAD患者中，与低tsh组相比，中位tsh （OR 0.277, 95% CI 0.078-0.991, P = 0.048）和高tsh （OR 0.163, 95% CI 0.036-0.750, P = 0.020）组与全因死亡率降低相关。此外，高TSH对HF事件有保护作用，在女性、年龄≥75岁和非非高血压亚组中也有同样的结果。结论：较高的基线TSH对房颤合并CAD患者院内全因死亡和心衰有保护作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.