Correlation between serum TSH concentrations and cardiovascular severity in patients undergoing PCI

doi:10.3969/j.issn.1673-8640.2015.05.019

Abstract

Abstract: Objective To investigate the correlation between serum thyroid-stimulating hormone(TSH)concentrations and cardiovascular severity in patients undergoing percutaneous coronary intervention(PCI). Methods Of 1 122 patients undergoing PCI, 1 000 who met inclusion criteria were classified into 3 groups according to serum TSH concentrations: normal,subclinical hypothyroidism and subclinical hyperthyroidism groups. The main outcomes were Gensini score with Gensini scores >50 defined as high cardiac risk and the percentage undergoing stent implantation. Results The percentages of patients with Gensini scores >50 differed significantly in normal and subclinical hypothyroidism groups(P=0.003). Binary Logistic regression analysis showed that subclinical hypothyroidism was an independent risk factor for cardiovascular disease[odds ratio (OR)=1.855, 95% confidence interval (CI): 1.244-2.766, P=0.002]. In contrast,Gensini score >50 and stent implantation did not correlate with TSH concentration in normal group. Conclusions Subclinical hypothyroidism is a risk factor for cardiovascular disease in patients undergoing PCI. The correlation between normal TSH concentrations and cardiovascular disease requires further investigation.

Key words: Thyroid-stimulating hormone, Subclinical hypothyroidism, Cardiovascular disease

CLC Number:

R446.1

WU Weiyun, WU Shengchao, YAN Hongmei, WU Jiong, GUO Wei, ZHANG Chunyan, SONG Binbin, PAN Baishen. Correlation between serum TSH concentrations and cardiovascular severity in patients undergoing PCI[J]. Laboratory Medicine, 2015, 30(5): 489-494.

Figures/Tables 6

References 9

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狭窄程度	积分	病变部位	系数
<25%	1	左主干	5
25%~49%	2	左前降支近段	2.5
50%~74%	4	左前降支中段	1.5
75%~89%	8	左前降支远段	1
90%~98%	16	第一对角支	1
≥99%	32	第二对角支	0.5
		左回旋支近段	2.5
		左回旋支中段	1.5
		左回旋支远段	1
		钝缘支	1
		后降支	1
		后侧支	0.5
		右冠状动脉(近、中、远段和后降支)	1

狭窄程度	积分	病变部位	系数
<25%	1	左主干	5
25%~49%	2	左前降支近段	2.5
50%~74%	4	左前降支中段	1.5
75%~89%	8	左前降支远段	1
90%~98%	16	第一对角支	1
≥99%	32	第二对角支	0.5
		左回旋支近段	2.5
		左回旋支中段	1.5
		左回旋支远段	1
		钝缘支	1
		后降支	1
		后侧支	0.5
		右冠状动脉(近、中、远段和后降支)	1

组别	例数	性别(例)		年龄 (岁)	TC (mmol/L)	TG (mmol/L)	LDL-C (mmol/L)			HDL-C (mmol/L)
组别	例数	男		年龄 (岁)	TC (mmol/L)							女
亚临床甲减组	125	80	45	67(61~76)	1.32±0.23	1.43(1.09~1.96)	1.07±0.25			1.06(0.90~1.23)
甲状腺功能正常组	867	646	221	64(57~71)	1.33±0.23	1.32(0.98~1.94)	1.07±0.26			1.11(0.94~1.31)
统计值		χ²=6.149		Z=-3.215	t=0.223	Z=2.197	t=-0.118			Z=-2.087
P值		0.013		0.001	0.82	0.138	0.912			0.037
组别	例数	UA (μmol/L)	Cr (μmol/L)	BUN (mmol/L)		FT3 (pmol/L)	FT4 (pmol/L)	ALT (U/L)			AST (U/L)
亚临床甲减组	125	352 (303~405)	80.34±22.69	5.70 (4.65~7.05)		4.2 (3.8~4.9)	14.70 (13.20~16.50)	18 (13~29)			21 (18~26)
甲状腺功能正常组	867	338 (285~396)	79.43±17.68	5.40 (4.50~6.30)		4.6 (4.2~4.9)	15.70 (14.40~17.20)	19 (13~29)			21 (17~26)
统计值		Z=3.547	t=-1.995	Z=5.11		Z=-4.511	Z=-4.973	Z=0.557			Z=0.252
P值		0.06	0.048	0.024		<0.001	0.001	0.455			0.616
组别	例数	GGT (U/L)		ALP (U/L)	Gensini积分		终点事件(例)
							Gensini积分			支架
							≤50		>50	是		否
亚临床甲减组	125	28(19~46)		68.00(57.00~78.50)		31.00(12.50~60.00)	76		49	44		81
甲状腺功能正常组	867	29(19~43)		70.00(58.00~84.00)		26.00(11.00~54.00)	639		228	314		553
统计值		Z=0.445		Z=3.266		Z=-1.934	χ²=9.036			χ²=0.049
P值		0.505		0.071		0.053	0.003			0.825

组别	例数	性别(例)		年龄 (岁)	TC (mmol/L)	TG (mmol/L)	LDL-C (mmol/L)			HDL-C (mmol/L)
组别	例数	男		年龄 (岁)	TC (mmol/L)							女
亚临床甲减组	125	80	45	67(61~76)	1.32±0.23	1.43(1.09~1.96)	1.07±0.25			1.06(0.90~1.23)
甲状腺功能正常组	867	646	221	64(57~71)	1.33±0.23	1.32(0.98~1.94)	1.07±0.26			1.11(0.94~1.31)
统计值		χ²=6.149		Z=-3.215	t=0.223	Z=2.197	t=-0.118			Z=-2.087
P值		0.013		0.001	0.82	0.138	0.912			0.037
组别	例数	UA (μmol/L)	Cr (μmol/L)	BUN (mmol/L)		FT3 (pmol/L)	FT4 (pmol/L)	ALT (U/L)			AST (U/L)
亚临床甲减组	125	352 (303~405)	80.34±22.69	5.70 (4.65~7.05)		4.2 (3.8~4.9)	14.70 (13.20~16.50)	18 (13~29)			21 (18~26)
甲状腺功能正常组	867	338 (285~396)	79.43±17.68	5.40 (4.50~6.30)		4.6 (4.2~4.9)	15.70 (14.40~17.20)	19 (13~29)			21 (17~26)
统计值		Z=3.547	t=-1.995	Z=5.11		Z=-4.511	Z=-4.973	Z=0.557			Z=0.252
P值		0.06	0.048	0.024		<0.001	0.001	0.455			0.616
组别	例数	GGT (U/L)		ALP (U/L)	Gensini积分		终点事件(例)
							Gensini积分			支架
							≤50		>50	是		否
亚临床甲减组	125	28(19~46)		68.00(57.00~78.50)		31.00(12.50~60.00)	76		49	44		81
甲状腺功能正常组	867	29(19~43)		70.00(58.00~84.00)		26.00(11.00~54.00)	639		228	314		553
统计值		Z=0.445		Z=3.266		Z=-1.934	χ²=9.036			χ²=0.049
P值		0.505		0.071		0.053	0.003			0.825

狭窄程度	组别	例数	左主干	左前降支近段	左前降支中段	左前降支远段	第一对角支	第二对角支
≥25%	甲状腺功能正常组	867	126(14.53)	238(27.45)	359(41.41)	36(4.15)	334(38.52)	125(14.42)
	亚临床甲减组	125	23(18.40)	35(28.00)	54(43.20)	6(4.80)	46(36.80)	21(16.80)
	P值		0.26	0.90	0.70	0.73	0.71	0.48
≥50%	甲状腺功能正常组	867	57(6.57)	189(21.80)	280(32.30)	26(3.00)	248(28.60)	97(11.19)
	亚临床甲减组	125	11(8.80)	30(24.00)	45(36.00)	6(4.80)	37(29.60)	14(11.20)
	P值		0.36	0.58	0.41	0.29	0.82	0.99
狭窄程度	组别	例数	左回旋支近段	左回旋支中段	左回旋支远段	钝缘支	后降支	后侧支	右冠状动脉及后降支
≥25%	甲状腺功能正常组	867	85(9.80)	144(16.61)	89(10.27)	126(14.53)	9(1.04)	100(11.53)	393(45.33)
	亚临床甲减组	125	17(13.60)	16(12.80)	16(12.80)	15(12.00)	1(0.80)	13(10.40)	57(45.60)
	P值		0.29	0.28	0.39	0.45	0.80	0.71	0.95
≥50%	甲状腺功能正常组	867	147(16.96)	213(24.57)	117(13.49)	187(21.57)	13(1.50)	134(15.46)	587(67.70)
	亚临床甲减组	125	22(17.60)	12(18.40)	22(17.60)	20(16.00)	3(2.40)	20(16.00)	71(56.80)
	P值		0.86	0.13	0.22	0.15	0.45	0.88	0.02