Bai Min-fu, Gao Chuan-yu, Yang Chao-kuan, Wang Xian-pei, Liu Jun, Qi Da-tun, Zhang You, Hao Pei-yuan, Li Mu-wei
Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, China.
Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, China; Henan Institute of Cardiovascular Epidemiology, Zhengzhou, China.
J Cardiol. 2014 Dec;64(6):496-500. doi: 10.1016/j.jjcc.2014.03.009. Epub 2014 Jun 17.
Abnormal thyroid hormone metabolism influences the occurrence and progress of coronary heart disease (CHD). The aim of the present study was to analyze the severity of coronary artery lesions and the prognosis of thyroid dysfunction patients admitted for coronary angiography (CAG).
From July 2011 to July 2012, 605 consecutive patients with suspected coronary heart disease admitted for CAG were selected. The patients were divided into three groups, based on their thyroid function prior to CAG: euthyroid group (n=455 patients), low T3 syndrome group (n=96 patients), and hypothyroidism group (n=54 patients). All patients underwent CAG. Then the severity of coronary artery lesions was assessed by Gensini scores. All patients were followed up for major adverse cardiac events.
The prevalence of CHD in low T3 syndrome group and hypothyroidism group was significantly higher than that in the euthyroid group (p<0.001 and p=0.004, respectively). Moreover, the severity of coronary artery lesions in low T3 syndrome group and hypothyroidism group was significantly greater than that in the euthyroid group (all p<0.001). Multinomial logistic regression analysis demonstrated that low T3 syndrome was an independent risk factor of coronary artery moderate [odds ratio (OR)=4.268, 95% CI: 3.294-7.450, p=0.016] and severe (OR=4.294, 95% CI: 2.259-9.703, p<0.001) lesions. The mean duration of follow-up was 15.3±3.8 months; patients with thyroid dysfunction had a significantly worse prognosis as compared to those in the euthyroid group for the composite end-point (p<0.01). Moreover, the incidence of the composite end-point (all-cause death, non-fatal myocardial infarction, and coronary revascularization) was significantly higher in low T3 syndrome group and hypothyroidism group compared with that of in the euthyroid group (all p<0.001).
The patients with hypothyroidism and low T3 syndrome had a high prevalence of CHD, increased severity of coronary artery lesions and poor prognosis.
甲状腺激素代谢异常会影响冠心病（CHD）的发生和发展。本研究旨在分析因冠状动脉造影（CAG）入院的甲状腺功能障碍患者的冠状动脉病变严重程度及预后情况。
选取2011年7月至2012年7月期间因CAG入院的605例疑似冠心病患者。根据CAG检查前的甲状腺功能将患者分为三组：甲状腺功能正常组（n = 455例患者）、低T3综合征组（n = 96例患者）和甲状腺功能减退组（n = 54例患者）。所有患者均接受CAG检查。然后通过Gensini评分评估冠状动脉病变的严重程度。对所有患者进行主要不良心脏事件的随访。
低T3综合征组和甲状腺功能减退组的冠心病患病率显著高于甲状腺功能正常组（分别为p < 0.001和p = 0.004）。此外，低T3综合征组和甲状腺功能减退组的冠状动脉病变严重程度显著大于甲状腺功能正常组（所有p < 0.001）。多项逻辑回归分析表明，低T3综合征是冠状动脉中度病变[比值比（OR）= 4.268，95%可信区间：3.294 - 7.450，p = 0.016]和重度病变（OR = 4.294，95%可信区间：2.259 - 9.703，p < 0.001）的独立危险因素。平均随访时间为15.3 ± 3.8个月；与甲状腺功能正常组相比，甲状腺功能障碍患者的复合终点预后明显更差（p < 0.01）。此外，低T3综合征组和甲状腺功能减退组的复合终点（全因死亡、非致命性心肌梗死和冠状动脉血运重建）发生率显著高于甲状腺功能正常组（所有p < 0.001）。
甲状腺功能减退和低T3综合征患者冠心病患病率高，冠状动脉病变严重程度增加，预后较差。
