Background:
Although hypothyroidism (HT) is known to be associated with worse cardiovascular outcomes, little data exists on its influence on clinical outcomes in patients undergoing percutaneous coronary interventions (PCI).
Methods:
In this prospective observational registry at a single center, we studied 1317 patients who underwent successful PCI (without complications) from ‘01-'12 and had thyroid function tests performed within 1 year prior to PCI. We excluded patients with cardiogenic shock at index PCI. We compared 1-year mortality and major adverse cardioascular events (MACE) between HT (both subclinical and overt hypothyroid patients, defined as TSH ≥5.5, n=78) and Euthyroid (ET) (TSH <5.5, n=1239) groups.
Results:
Both the groups were similar in baseline clinical and angiographic characteristics except for higher prevalence of prior myocardial infarction (MI) and thyroid supplement use in HT group (table 1). At 1-year, HT was associated with higher all cause mortality as compared to ET group (14%[11/78] Vs 6.7%[83/1239], p=0.014) and remained an independent predictor of mortality in the multivariate analysis (adjusted odds ratio=2.6, 95% CI: 1.2-5.3, p=0.011). There was a trend towards higher MACE in the HT vs ET group, although this was not statistically significant. (21% [16/78] Vs 16% [203/1239]respectively, p=0.342, adjusted odds ratio=1.3, 95%CI: 0.7-2.3, p=0.455) Individual 1-yr outcomes are shown in Figure 1.
Conclusion:
Although there was no difference in MACE, HT was associated with higher all cause mortality after PCI. We suggest monitoring of thyroid function for patients who undergo PCI. Treatment may improve survival in hypothyroid patients post PCI, however further outcome studies are needed.
Contrast induced nephropathy in percutaneous coronary interventions – Risk prediction and clinical outcomes
