Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?

Arq Bras Cardiol. 2018 Feb;110(2):113-118. doi: 10.5935/abc.20180019.
[Article in English, Portuguese]

Abstract

Background: Some small studies have related higher levels of thyrotropin (TSH) to potentially worse prognosis in acute coronary syndromes. However, this relationship remains uncertain.

Objective: To analyze the outcomes of patients with acute coronary syndromes in relation to the value of TSH at admission.

Methods: Observational and retrospective study with 505 patients (446 in group I [TSH ≤ 4 mIU/L] and 59 in group II [TSH > 4 mIU/L]) with acute coronary syndromes between May 2010 and May 2014. We obtained data about comorbidities and the medications used at the hospital. The primary endpoint was in-hospital all-cause death. The secondary endpoint included combined events (death, non-fatal unstable angina or myocardial infarction, cardiogenic shock, bleeding and stroke). Comparisons between groups were made by one-way ANOVA and chi-square test. Multivariate analysis was determined by logistic regression. Analyses were considered significant when p < 0.05.

Results: Significant differences between groups I and II were observed regarding the use of enoxaparin (75.2% vs. 57.63%, p = 0.02) and statins (84.08% vs. 71.19%, p < 0.0001), previous stroke (5.83% vs. 15.25%, p = 0.007), combined events (14.80% vs. 27.12%, OR = 3.05, p = 0.004), cardiogenic shock (4.77% vs. 6.05%, OR = 4.77, p = 0.02) and bleeding (12.09% vs. 15.25%, OR = 3.36, p = 0.012).

Conclusions: In patients with acute coronary syndromes and TSH > 4 mIU/L at admission, worse prognosis was observed, with higher incidences of in-hospital combined events, cardiogenic shock and bleeding.

Publication types

  • Observational Study

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / mortality
  • Analysis of Variance
  • Brazil / epidemiology
  • Cardiovascular Diseases / mortality
  • Female
  • Hospital Mortality
  • Humans
  • Hypothyroidism / blood
  • Hypothyroidism / complications
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Thyrotropin / blood*

Substances

  • Thyrotropin