Short-term outcomes among patients with subclinical hypothyroidism undergoing primary percutaneous coronary intervention.

Q3 Medicine Ghana Medical Journal Pub Date : 2023-01-01 DOI:10.4314/gmj.v57i1.6
Abdulameer J Al-Gburi, Saba R Al-Obaidi, Wasnaa H Abdullah
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Abstract

Objectives: This study aimed to examine possible associations between previously undiagnosed subclinical hypothyroidism and short-term outcomes and mortality in a sample of Iraqi patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

Design: This is a prospective observational cohort study.

Setting: The study was conducted in a single tertiary referral centre in Baghdad, Iraq.

Participants: Thyroid-stimulating hormone and free T4 levels were measured in 257 patients hospitalised with ST-elevation myocardial infarction who underwent primary percutaneous coronary intervention between January 2020 and March 2022.

Main outcome measures: Adverse cardiovascular and renal events during hospitalisation and 30-day mortality were observed.

Results: Previously undiagnosed subclinical hypothyroidism was detected in 36/257 (14%) ST-elevation myocardial infarction patients and observed more commonly in females than males. Patients with subclinical hypothyroidism had significantly worse short-term outcomes, including higher rates of suboptimal TIMI Flow (< III) (p =0.014), left ventricular ejection fraction ≤ 40% (p=0.035), Killip class >I (p=0.042), cardiogenic shock (p =0.016), cardiac arrest in the hospital (p= 0.01), and acute kidney injury (p= 0.044). Additionally, 30-day mortality was significantly higher in patients with subclinical hypothyroidism (p= 0.029).

Conclusion: Subclinical hypothyroidism previously undiagnosed and untreated had a significant association with adverse short-term outcomes and higher short-term mortality within 30 days compared to euthyroid patients undergoing primary percutaneous coronary intervention. Routine thyroid function testing during these patients' hospitalisation may be warranted.

Funding: None declared.

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原发性经皮冠状动脉介入治疗亚临床甲状腺功能减退患者的短期疗效
目的:本研究旨在探讨在伊拉克接受st段抬高型心肌梗死的经皮冠状动脉介入治疗的患者样本中,先前未确诊的亚临床甲状腺功能减退与短期预后和死亡率之间可能存在的关联。设计:这是一项前瞻性观察队列研究。环境:研究是在伊拉克巴格达的一个三级转诊中心进行的。参与者:在2020年1月至2022年3月期间,对257例st段抬高型心肌梗死住院患者进行了初步经皮冠状动脉介入治疗,测量了促甲状腺激素和游离T4水平。主要结局指标:观察住院期间心血管和肾脏不良事件以及30天死亡率。结果:既往未确诊的亚临床甲状腺功能减退在36/257 (14%)st段抬高型心肌梗死患者中检测到,女性比男性更常见。亚临床甲状腺功能减退患者的短期预后明显较差,包括TIMI血流次优(< III) (p= 0.014)、左心室射血分数≤40% (p=0.035)、Killip分级>I (p=0.042)、心源性休克(p= 0.016)、院内心脏骤停(p= 0.01)和急性肾损伤(p= 0.044)的发生率较高。此外,亚临床甲状腺功能减退患者的30天死亡率显著更高(p= 0.029)。结论:与接受初级经皮冠状动脉介入治疗的甲状腺功能正常患者相比,先前未诊断和未经治疗的亚临床甲状腺功能减退与不良短期预后和30天内较高的短期死亡率有显著相关性。在这些患者住院期间进行常规甲状腺功能检查是有必要的。资金:未宣布。
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来源期刊
Ghana Medical Journal
Ghana Medical Journal Medicine-Medicine (all)
CiteScore
1.10
自引率
0.00%
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0
审稿时长
20 weeks
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