Kumar Ritesh, Sinha Rashmi, Gunjan Gagan, Singh Sanjay K
Department of General Medicine, Mahatma Gandhi Memorial Medical College and Hospital, Ranchi, IND.
Department of General Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND.
Cureus. 2024 Mar 8;16(3):e55793. doi: 10.7759/cureus.55793. eCollection 2024 Mar.
Thyroid-releasing hormones are pivotal in regulating cardiovascular (CVS) function and maintaining its hemodynamics and homeostasis. Even a minor alteration in thyroid function has an enormous implication on CVS morbidity and mortality. Moreover, hypothyroidism was found to be a potential menace for coronary artery disease (CAD). The objective of this study was to determine the role of thyroid-releasing hormones in patients suffering from acute coronary syndrome (ACS).
Among a cohort of 100 patients suffering with ACS, a complete history and clinical information followed by physical examination and electrocardiography were recorded. Blood samples were also collected to record the blood sugar levels i.e., fasting blood sugar (FBS), postprandial blood sugar (PPBS), and thyroid profile, including free thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and reverse triiodothyronine (rT3). The data was analyzed using SPSS version 26 software (IBM Corp., Armonk, NY, USA).
The study identified alterations in the thyroid hormone levels in 27% of patients suffering from ACS. The prevalence of euthyroid sick syndrome was found to be 59.3%, while subclinical hypothyroidism and subclinical hyperthyroidism were reported among 18.5% and 14.8% of patients respectively. There was no significant difference found between males and females. The study illustrated a greater occurrence of aberrant thyroid hormone profiles among those aged 40-60 years. The ST-elevated myocardial infarction (STEMI) group had a statistically significant higher prevalence of an aberrant thyroid hormone profile compared to the non-ST-elevated myocardial infarction (NSTEMI) and unstable angina (UA) groups (p=0.02). A total of nine patients died with ACS and all of those had statistically significant low fT3 and TSH values while higher rT3 values (p<0.05).
An atypical thyroid status has been found to elevate the likelihood of developing CAD and experiencing CVS mortality. This condition can impact ventricular function and serum cholesterol levels as well as heart rate and rhythm. Therefore, understanding this relationship could potentially lead to improved treatment strategies for individuals with ACS which will further prevent major CVS complications.
甲状腺释放激素在调节心血管(CVS)功能以及维持其血液动力学和内环境稳定方面起着关键作用。即使甲状腺功能出现微小改变,也会对心血管疾病的发病率和死亡率产生重大影响。此外,甲状腺功能减退被发现是冠状动脉疾病(CAD)的一个潜在威胁。本研究的目的是确定甲状腺释放激素在急性冠状动脉综合征(ACS)患者中的作用。
在100例ACS患者队列中,记录完整的病史、临床信息,随后进行体格检查和心电图检查。还采集血样以记录血糖水平,即空腹血糖(FBS)、餐后血糖(PPBS)以及甲状腺指标,包括游离促甲状腺激素(TSH)、游离甲状腺素(fT4)、游离三碘甲状腺原氨酸(fT3)和反三碘甲状腺原氨酸(rT3)。使用SPSS 26版软件(美国纽约州阿蒙克市IBM公司)对数据进行分析。
该研究发现27%的ACS患者甲状腺激素水平有改变。甲状腺功能正常的病态综合征患病率为59.3%,而亚临床甲状腺功能减退和亚临床甲状腺功能亢进分别在18.5%和14.8%的患者中被报告。男性和女性之间未发现显著差异。该研究表明40 - 60岁人群中异常甲状腺激素谱的发生率更高。与非ST段抬高型心肌梗死(NSTEMI)和不稳定型心绞痛(UA)组相比,ST段抬高型心肌梗死(STEMI)组异常甲状腺激素谱的患病率在统计学上显著更高(p = 0.02)。共有9例ACS患者死亡,所有这些患者的fT3和TSH值在统计学上显著较低,而rT3值较高(p < 0.05)。
已发现非典型甲状腺状态会增加患CAD和心血管疾病死亡率的可能性。这种情况会影响心室功能、血清胆固醇水平以及心率和心律。因此,了解这种关系可能会为ACS患者带来改进的治疗策略,进而预防主要的心血管并发症。