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SAT-LB014 Subclinical Hypothyroidism and All-cause Mortality among Patients with Myocardial Infarction

Introduction: Subclinical hypothyroidism (SCH) is defined as an elevated serum thyroid-stimulating hormone (TSH) level with a normal serum free thyroxine level (FT4). The aim of this study was to investigate the association between SCH and short and long term all-cause mortality in a large cohort of...

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Autores principales: Izkhakov, Elena, Zahler, David, Rozenfeld, Keren-Lee, Ravid, Dor, Banai, Shmuel, Yan, Topilsky, Shacham, Yacov
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Endocrine Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552075/
http://dx.doi.org/10.1210/js.2019-SAT-LB014
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author Izkhakov, Elena
Zahler, David
Rozenfeld, Keren-Lee
Ravid, Dor
Banai, Shmuel
Yan, Topilsky
Shacham, Yacov
author_facet Izkhakov, Elena
Zahler, David
Rozenfeld, Keren-Lee
Ravid, Dor
Banai, Shmuel
Yan, Topilsky
Shacham, Yacov
author_sort Izkhakov, Elena
collection PubMed
description Introduction: Subclinical hypothyroidism (SCH) is defined as an elevated serum thyroid-stimulating hormone (TSH) level with a normal serum free thyroxine level (FT4). The aim of this study was to investigate the association between SCH and short and long term all-cause mortality in a large cohort of patients with ST elevation myocardial infarction (STEMI). Methods: We evaluated TSH and FT4 levels of 1593 STEMI patients without known history of hypothyroidism or thyroid replacement treatment who were admitted to the coronary care unit and underwent primary PCI between January 2008 and August 2017. The presence of SCH was defined as TSH levels ≥5 mU/ml in the presence of normal free T4 levels. Patients were assessed for short (30 days) and long term (1 year) outcomes. Results: The presence of SCH was demonstrated in 68/1593 (4.2%) of STEMI patients. Patients with SCH had lower left ventricular ejection fraction, older age (more than 60), family history of CAD and were associated independently with 30-day mortality (OR 3.24, 95% CI: 1.22-8.63, p=0.02). Long term mortality was significantly higher among those with SCH (16/68 24 %) than those without SCH (202/1525, 13 %; p<0.001). Following the performance of multivariable cox regression model, SCH was independently associated with long term mortality following STEMI (HR 2.17, 95% CI:1.24-3.79, p=0.007). Conclusions: Among STEMI patients treated with primary coronary intervention the presence of SCH is common and may serve as a significant marker for higher short and long term mortality. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.
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spelling pubmed-65520752019-06-13 SAT-LB014 Subclinical Hypothyroidism and All-cause Mortality among Patients with Myocardial Infarction Izkhakov, Elena Zahler, David Rozenfeld, Keren-Lee Ravid, Dor Banai, Shmuel Yan, Topilsky Shacham, Yacov J Endocr Soc Cardiovascular Endocrinology Introduction: Subclinical hypothyroidism (SCH) is defined as an elevated serum thyroid-stimulating hormone (TSH) level with a normal serum free thyroxine level (FT4). The aim of this study was to investigate the association between SCH and short and long term all-cause mortality in a large cohort of patients with ST elevation myocardial infarction (STEMI). Methods: We evaluated TSH and FT4 levels of 1593 STEMI patients without known history of hypothyroidism or thyroid replacement treatment who were admitted to the coronary care unit and underwent primary PCI between January 2008 and August 2017. The presence of SCH was defined as TSH levels ≥5 mU/ml in the presence of normal free T4 levels. Patients were assessed for short (30 days) and long term (1 year) outcomes. Results: The presence of SCH was demonstrated in 68/1593 (4.2%) of STEMI patients. Patients with SCH had lower left ventricular ejection fraction, older age (more than 60), family history of CAD and were associated independently with 30-day mortality (OR 3.24, 95% CI: 1.22-8.63, p=0.02). Long term mortality was significantly higher among those with SCH (16/68 24 %) than those without SCH (202/1525, 13 %; p<0.001). Following the performance of multivariable cox regression model, SCH was independently associated with long term mortality following STEMI (HR 2.17, 95% CI:1.24-3.79, p=0.007). Conclusions: Among STEMI patients treated with primary coronary intervention the presence of SCH is common and may serve as a significant marker for higher short and long term mortality. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO. Endocrine Society 2019-04-30 /pmc/articles/PMC6552075/ http://dx.doi.org/10.1210/js.2019-SAT-LB014 Text en Copyright © 2019 Endocrine Society https://creativecommons.org/licenses/by-nc-nd/4.0/ This article has been published under the terms of the Creative Commons Attribution Non-Commercial, No-Derivatives License (CC BY-NC-ND; https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Cardiovascular Endocrinology
Izkhakov, Elena
Zahler, David
Rozenfeld, Keren-Lee
Ravid, Dor
Banai, Shmuel
Yan, Topilsky
Shacham, Yacov
SAT-LB014 Subclinical Hypothyroidism and All-cause Mortality among Patients with Myocardial Infarction
title SAT-LB014 Subclinical Hypothyroidism and All-cause Mortality among Patients with Myocardial Infarction
title_full SAT-LB014 Subclinical Hypothyroidism and All-cause Mortality among Patients with Myocardial Infarction
title_fullStr SAT-LB014 Subclinical Hypothyroidism and All-cause Mortality among Patients with Myocardial Infarction
title_full_unstemmed SAT-LB014 Subclinical Hypothyroidism and All-cause Mortality among Patients with Myocardial Infarction
title_short SAT-LB014 Subclinical Hypothyroidism and All-cause Mortality among Patients with Myocardial Infarction
title_sort sat-lb014 subclinical hypothyroidism and all-cause mortality among patients with myocardial infarction
topic Cardiovascular Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552075/
http://dx.doi.org/10.1210/js.2019-SAT-LB014
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