Department of Medicine, College of Medicine, al-Mustansiriyah University, Baghdad, Iraq.
Department of Obstetrics and Gynecology, College of Medicine, al-Nahrain University, Baghdad, Iraq.
Ghana Med J. 2023 Jan;57(1):37-42. doi: 10.4314/gmj.v57i1.6.
This study aimed to examine possible associations between previously undiagnosed subclinical hypothyroidism and short-term outcomes and mortality in a sample of Iraqi patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.
This is a prospective observational cohort study.
The study was conducted in a single tertiary referral centre in Baghdad, Iraq.
Thyroid-stimulating hormone and free T4 levels were measured in 257 patients hospitalised with ST-elevation myocardial infarction who underwent primary percutaneous coronary intervention between January 2020 and March 2022.
Adverse cardiovascular and renal events during hospitalisation and 30-day mortality were observed.
Previously undiagnosed subclinical hypothyroidism was detected in 36/257 (14%) ST-elevation myocardial infarction patients and observed more commonly in females than males. Patients with subclinical hypothyroidism had significantly worse short-term outcomes, including higher rates of suboptimal TIMI Flow (< III) (p =0.014), left ventricular ejection fraction ≤ 40% (p=0.035), Killip class >I (p=0.042), cardiogenic shock (p =0.016), cardiac arrest in the hospital (p= 0.01), and acute kidney injury (p= 0.044). Additionally, 30-day mortality was significantly higher in patients with subclinical hypothyroidism (p= 0.029).
Subclinical hypothyroidism previously undiagnosed and untreated had a significant association with adverse short-term outcomes and higher short-term mortality within 30 days compared to euthyroid patients undergoing primary percutaneous coronary intervention. Routine thyroid function testing during these patients' hospitalisation may be warranted.
None declared.
本研究旨在探讨伊拉克 ST 段抬高型心肌梗死患者行直接经皮冠状动脉介入治疗（PPCI）中，未确诊的亚临床甲状腺功能减退症与短期结局和死亡率之间的可能关联。
这是一项前瞻性观察队列研究。
研究在伊拉克巴格达的一家单一的三级转诊中心进行。
2020 年 1 月至 2022 年 3 月期间，257 例因 ST 段抬高型心肌梗死住院并接受 PPCI 的患者测量了促甲状腺激素和游离 T4 水平。
住院期间和 30 天死亡率的不良心血管和肾脏事件。
在 257 例 ST 段抬高型心肌梗死患者中发现 36 例（14%）存在未确诊的亚临床甲状腺功能减退症，女性比男性更常见。亚临床甲状腺功能减退症患者的短期结局明显较差，包括 TIMI 血流较差（< III）发生率较高（p=0.014）、左心室射血分数≤40%（p=0.035）、Killip 分级>I 级（p=0.042）、心源性休克（p=0.016）、院内心脏骤停（p=0.01）和急性肾损伤（p=0.044）发生率较高。此外，亚临床甲状腺功能减退症患者 30 天死亡率明显更高（p=0.029）。
与甲状腺功能正常的行 PPCI 患者相比，未确诊和未经治疗的亚临床甲状腺功能减退症与不良的短期结局以及 30 天内的高短期死亡率显著相关。这些患者住院期间可能需要进行常规甲状腺功能检测。
无。
