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Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery

BACKGROUND: The aim of this study was to determine the associations between subclinical hypothyroidism (SCH) and long-term cardiovascular outcomes after coronary artery bypass grafting (CABG) or heart valve surgery (HVS). METHODS: We retrospectively reviewed and compared all-cause mortality, cardiov...

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Autores principales: Kim, Hana, Kong, Sung Hye, Moon, Jae Hoon, Kim, Sang Yoon, Park, Kay-Hyun, Kim, Jun Sung, Choh, Joong Haeng, Park, Young Joo, Lim, Cheong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Endocrine Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386124/
https://www.ncbi.nlm.nih.gov/pubmed/32615715
http://dx.doi.org/10.3803/EnM.2020.35.2.308
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author Kim, Hana
Kong, Sung Hye
Moon, Jae Hoon
Kim, Sang Yoon
Park, Kay-Hyun
Kim, Jun Sung
Choh, Joong Haeng
Park, Young Joo
Lim, Cheong
author_facet Kim, Hana
Kong, Sung Hye
Moon, Jae Hoon
Kim, Sang Yoon
Park, Kay-Hyun
Kim, Jun Sung
Choh, Joong Haeng
Park, Young Joo
Lim, Cheong
author_sort Kim, Hana
collection PubMed
description BACKGROUND: The aim of this study was to determine the associations between subclinical hypothyroidism (SCH) and long-term cardiovascular outcomes after coronary artery bypass grafting (CABG) or heart valve surgery (HVS). METHODS: We retrospectively reviewed and compared all-cause mortality, cardiovascular mortality, and cardiovascular events in 461 patients who underwent CABG and 104 patients who underwent HVS. RESULTS: During a mean±standard deviation follow-up duration of 7.6±3.8 years, there were 187 all-cause deaths, 97 cardiovascular deaths, 127 major adverse cardiovascular events (MACE), 11 myocardial infarctions, one unstable angina, 70 strokes, 30 hospitalizations due to heart failure, 101 atrial fibrillation, and 33 coronary revascularizations. The incidence of all-cause mortality after CABG was significantly higher in patients with SCH (n=36, 55.4%) than in euthyroid patients (n=120, 30.3%), with a hazard ratio of 1.70 (95% confidence interval, 1.10 to 2.63; P=0.018) after adjustment for age, sex, current smoking status, body mass index, underlying diseases, left ventricular dysfunction, and emergency operation. Interestingly, low total triiodothyronine (T3) levels in euthyroid patients who underwent CABG were significantly associated with increased risks of all-cause mortality, cardiovascular mortality, and MACE, but those associations were not observed in HVS patients. Both free thyroxine and thyroid-stimulating hormone levels in euthyroid patients were not related with any cardiovascular outcomes in either the CABG or HVS group. CONCLUSION: SCH or low total T3 might be associated with a poor prognosis after CABG, but not after HVS, implying that preoperative thyroid hormonal status may be important in ischemic heart disease patients.
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spelling pubmed-73861242020-07-29 Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery Kim, Hana Kong, Sung Hye Moon, Jae Hoon Kim, Sang Yoon Park, Kay-Hyun Kim, Jun Sung Choh, Joong Haeng Park, Young Joo Lim, Cheong Endocrinol Metab (Seoul) Original Article BACKGROUND: The aim of this study was to determine the associations between subclinical hypothyroidism (SCH) and long-term cardiovascular outcomes after coronary artery bypass grafting (CABG) or heart valve surgery (HVS). METHODS: We retrospectively reviewed and compared all-cause mortality, cardiovascular mortality, and cardiovascular events in 461 patients who underwent CABG and 104 patients who underwent HVS. RESULTS: During a mean±standard deviation follow-up duration of 7.6±3.8 years, there were 187 all-cause deaths, 97 cardiovascular deaths, 127 major adverse cardiovascular events (MACE), 11 myocardial infarctions, one unstable angina, 70 strokes, 30 hospitalizations due to heart failure, 101 atrial fibrillation, and 33 coronary revascularizations. The incidence of all-cause mortality after CABG was significantly higher in patients with SCH (n=36, 55.4%) than in euthyroid patients (n=120, 30.3%), with a hazard ratio of 1.70 (95% confidence interval, 1.10 to 2.63; P=0.018) after adjustment for age, sex, current smoking status, body mass index, underlying diseases, left ventricular dysfunction, and emergency operation. Interestingly, low total triiodothyronine (T3) levels in euthyroid patients who underwent CABG were significantly associated with increased risks of all-cause mortality, cardiovascular mortality, and MACE, but those associations were not observed in HVS patients. Both free thyroxine and thyroid-stimulating hormone levels in euthyroid patients were not related with any cardiovascular outcomes in either the CABG or HVS group. CONCLUSION: SCH or low total T3 might be associated with a poor prognosis after CABG, but not after HVS, implying that preoperative thyroid hormonal status may be important in ischemic heart disease patients. Korean Endocrine Society 2020-06 2020-06-30 /pmc/articles/PMC7386124/ /pubmed/32615715 http://dx.doi.org/10.3803/EnM.2020.35.2.308 Text en Copyright © 2020 Korean Endocrine Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Hana
Kong, Sung Hye
Moon, Jae Hoon
Kim, Sang Yoon
Park, Kay-Hyun
Kim, Jun Sung
Choh, Joong Haeng
Park, Young Joo
Lim, Cheong
Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
title Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
title_full Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
title_fullStr Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
title_full_unstemmed Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
title_short Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
title_sort subclinical hypothyroidism affects the long-term outcomes of patients who undergo coronary artery bypass grafting surgery but not heart valve surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386124/
https://www.ncbi.nlm.nih.gov/pubmed/32615715
http://dx.doi.org/10.3803/EnM.2020.35.2.308
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