AlQahtani Abdulrahman, Alakkas Ziyad, Althobaiti Fayez, Alosaimi Mohammed, Abuzinadah Baraa, Abdulkhalik Elshazly, Alswat Khaled
Internal Medicine Department, King Abdul Aziz Specialist Hospital, Taif, Makkah, Saudi Arabia.
Consultant Cardiology, Cardiology Department, Al Azhar University, Cairo, Egypt.
Int J Gen Med. 2021 Feb 18;14:505-514. doi: 10.2147/IJGM.S292750. eCollection 2021.
Cardiovascular disease is one of the main causes of hospital admission and mortality, and thyroid dysfunction increases the risk of developing acute or exacerbation of chronic cardiac conditions. The aim of this study is to investigate the prevalence of thyroid hormone abnormality among patients in the cardiac care unit (CCU) patients and its relation to admission diagnosis, clinical, biochemical data, and hospital-related outcomes.
We conducted a retrospective cohort observational that included adult patients who were admitted to the CCU. We excluded those with known thyroid dysfunction and those who received amiodarone or IV contrast.
A total of 374 patients with a mean age of 62.7+14.7 years old were included. Ischemic changes were observed in 70.6% of the patients based on the admission diagnosis. In comparison to the non-ischemic group, the ischemic group was more likely to be male (P=0.010), to be active/former smokers (P=0.011), to have diabetes (P=0.009), to have diastolic dysfunction (P=<0.001), to have undergone thrombolysis (P=<0.001), and to have been referred to a tertiary center (P=<0.001). Euthyroidism was observed in 57.8% of the patients based on the thyroid function test at admission. Compared to patients with thyroid dysfunction, those with Euthyroidism were more likely to be active/former smokers (P=0.002), to have lower heart rates (P=0.018), to not have chronic kidney disease (P=0.016), to not have heart failure (P=0.006), to have lower thyroid-stimulating hormone (TSH) levels (P=<0.001), and to have lower tricuspid regurgitation (P=0.042).
Thyroid dysfunction is common among patients admitted to the CCU. Non-significant positive correlations between TSH and hospitalization length, tertiary center referral, 30-day readmission, and in-hospital mortality when adjusting for potential confounders.
心血管疾病是住院和死亡的主要原因之一,甲状腺功能障碍会增加患急性或慢性心脏病加重的风险。本研究的目的是调查心脏监护病房(CCU)患者中甲状腺激素异常的患病率及其与入院诊断、临床、生化数据和医院相关结局的关系。
我们进行了一项回顾性队列观察研究,纳入了入住CCU的成年患者。我们排除了已知甲状腺功能障碍的患者以及接受胺碘酮或静脉造影剂的患者。
共纳入374例患者,平均年龄为62.7±14.7岁。根据入院诊断,70.6%的患者观察到缺血性改变。与非缺血组相比,缺血组更可能为男性(P=0.010)、为现吸烟者/既往吸烟者(P=0.011)、患有糖尿病(P=0.009)、患有舒张功能障碍(P<0.001)接受过溶栓治疗(P<0.001)以及被转诊至三级中心(P<0.001)。根据入院时的甲状腺功能检查,57.8%的患者甲状腺功能正常。与甲状腺功能障碍患者相比,甲状腺功能正常的患者更可能为现吸烟者/既往吸烟者(P=0.002)、心率较低(P=0.018)、没有慢性肾脏病(P=0.016)、没有心力衰竭(P=0.006)、促甲状腺激素(TSH)水平较低(P<(0.001)以及三尖瓣反流较低(P=0.042)。
甲状腺功能障碍在入住CCU的患者中很常见。在调整潜在混杂因素后,TSH与住院时间、转诊至三级中心、30天再入院率和院内死亡率之间存在非显著正相关。