EVALUATION OF CARDIOVASCULAR RISK AND MYOCARDIAL PERFUSION IN PATIENTS WITH RADICALLY TREATED DIFFERENTIATED THYROID CARCINOMA AND REPEATED EPISODES OF IATROGENIC HYPOTHYROIDISM.

CONTEXT

Patients with radically treated differentiated thyroid carcinoma (DTC) undergo multiple episodes of iatrogenously-acquired hypothyroidism for the oncological follow-up. In some patients, this elevates high-sensitive C-reactive protein (hsCRP), a cardiovascular risk biomarker.

OBJECTIVE

We wanted to determine if there is any correlation between repeated hypothyroidism episodes, elevated hsCRP and an increased cardiovascular risk as stated through myocardial perfusion.

DESIGN

Between July 2014-January 2015, we analyzed serological levels of hsCRP for identifying our patients' cardiovascular risk; we performed a myocardial perfusion scintigraphy to observe the alterations.

SUBJECTS AND METHODS

We included 27 patients (n=27), mean age of 52±10: CI (95%),14 female, all disease- free after thyroidectomy, radioiodine ablation and chronic thyroid hormone treatment. We assigned the cardiovascular risk category for each patient according to hsCRP levels; all patients underwent a myocardial perfusion scintigraphy in order to determine the cardiac perfusion index (CPI).

RESULTS

hsCRP has been higher in > 65 years old male patients with more than 5 thyroid hormone withholdings. hsCRP is significantly associated with CPI (p=0.001). Spearman's rank correlation indicates a strongly positive linear correlation between these two parameters (r=0.745).

CONCLUSIONS

Repeated thyroid hormonal withdrawals in patients with DTC during the long-term follow-up elevated hsCRP at cardiovascular risk levels, having an impact on myocardial perfusion.