Department of Cardiology, Shanghai Changzheng Hospital, Navy Medical University, Shanghai, China.
Department of Cardiology, Fujian Medical University Union Hospital, Fujian Institute of Coronary Artery Disease, Fuzhou, China.
Front Endocrinol (Lausanne). 2022 Jun 23;13:917498. doi: 10.3389/fendo.2022.917498. eCollection 2022.
With the rapid advance in percutaneous coronary intervention (PCI) technology, patients absorb large volume of iodinated contrast media (ICM). Recent studies suggested that ICM may lead to hyperthyroidism, but the association between ICM volume and thyroid is still unclear. We sought to evaluate the long-term influence of ICM on thyroid dysfunction and disease in patients received PCI.
This single-center retrospective study included consecutive coronary artery disease (CAD) patients. A covariance (ANCOVA) model was performed to evaluate the change of serum TSH, FT3 and FT4 before and one-year after the PCI procedure. Restricted cubic splines and logistic regression were performed to evaluate the association between ICM volume and thyroid disease.
2062 patients met inclusion criteria (1381 patients in the low-volume group and 681 patients in the high-volume group). The high-volume group was 0.238 ± 0.092 pmol/L higher than the low-volume group ( = 0.010) in the serum FT4. Restricted cubic splines show that there were linear dose-response relationships for ICM volume and composite endpoint and hyperthyroidism. In all models, there were significant differences in composite endpoint between the two groups. ( 1.75, 95% (1.05, 2.92), = 0.032, 1.73, 95% (1.01-2.96), = 0.032 and 1.83, 95% (1.09-3.06), = 0.022, respectively). The positive results were also showed for hyperthyroidism in all models ( 2.35, 95% (1.14-4.84), = 0.021, 10.36, 95% (1.20-89.00), = 0.033 and 2.35, 95% CI (1.13-4.87), = 0.022, respectively).
The present analysis gives an overview that ICM volume is associated with an increased risk of thyroid dysfunction and thyroid disease.
随着经皮冠状动脉介入治疗（PCI）技术的快速发展，患者接受了大量的碘造影剂（ICM）。最近的研究表明，ICM 可能导致甲状腺功能亢进，但 ICM 体积与甲状腺之间的关系仍不清楚。我们旨在评估 PCI 后 ICM 对患者甲状腺功能障碍和疾病的长期影响。
这项单中心回顾性研究纳入了连续的冠心病（CAD）患者。采用协方差（ANCOVA）模型评估 PCI 术前和术后 1 年血清 TSH、FT3 和 FT4 的变化。采用受限立方样条和逻辑回归评估 ICM 体积与甲状腺疾病的关系。
2062 名患者符合纳入标准（低剂量组 1381 例，高剂量组 681 例）。与低剂量组相比，高剂量组血清 FT4 高 0.238±0.092 pmol/L（ = 0.010）。受限立方样条显示，ICM 体积与复合终点和甲状腺功能亢进之间存在线性剂量反应关系。在所有模型中，两组之间的复合终点均有显著差异。（1.75，95%CI（1.05，2.92）， = 0.032；1.73，95%CI（1.01-2.96）， = 0.032；1.83，95%CI（1.09-3.06）， = 0.022）。所有模型中，甲状腺功能亢进的阳性结果也相似（2.35，95%CI（1.14-4.84）， = 0.021；10.36，95%CI（1.20-89.00）， = 0.033；2.35，95%CI（1.13-4.87）， = 0.022）。
本分析概述了 ICM 体积与甲状腺功能障碍和甲状腺疾病风险增加有关。
