Relation between thyroid-stimulating hormone and the occurrence of cardiovascular events and mortality in patients with manifest vascular diseases

2011 ◽  
Vol 19 (4) ◽  
pp. 864-873 ◽  
Author(s):  
Jan Westerink ◽  
Yolanda van der Graaf ◽  
Daniël R Faber ◽  
Wilko Spiering ◽  
Frank LJ Visseren
Keyword(s):  
Myocardial Infarction ◽  
Vascular Disease ◽  
Vascular Diseases ◽  
Thyroid Stimulating Hormone ◽  
Tissue Thickness ◽  
Normal Range ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Visceral Adipose ◽  
Tsh Levels

Aims: To investigate whether levels of thyroid-stimulating hormone (TSH) within the normal range are associated with an increased risk of new vascular events and mortality in patients with clinical manifest vascular diseases and whether this relation is influenced by adiposity. Methods and results: Prospective cohort study in 2443 patients (1790 men and 653 women) with clinical manifest vascular disease and TSH levels in the normal range. Median follow up was 2.7 (interquartile range 1.4–3.9) years. Clinical endpoints of interest were: myocardial infarction, stroke, vascular death, and all-cause mortality. In patients with manifest vascular disease, the prevalence of (subclinical) hypothyroidism was 5.7%, while 3.6% had (subclinical) hyperthyroidism. An increase in 1 unit of TSH was associated with a 33% higher risk (HR 1.33; 95% CI 1.03–1.73) for the occurrence of myocardial infarction, adjusted for age, gender, renal function, and smoking. In patients with a body mass index (BMI) below the median of 26.7 kg/m2 the HR per unit TSH for myocardial infarction was 1.55 (95% CI 1.08–2.21) compared to 1.18 (95% CI 0.81–1.71) in patients with a BMI ≥26.7 kg/m2. Visceral adipose tissue thickness below the median (≤8.8 cm) was associated with higher HR per unit TSH for myocardial infarction (HR 1.69; 95% CI 1.21–2.35) compared to visceral adipose tissue thickness >8.9 cm (HR 1.00; 95% CI 0.66–1.49). There was no relation between TSH and risk of stroke, vascular death, the combined endpoint, or all-cause mortality. Conclusion: Higher TSH levels within the normal range are associated with an increased risk of myocardial infarction, in patients with clinical manifest vascular disease. This relation is most prominent in patients without visceral obesity.

scholarly journals Associations of Visceral Adipose Tissue and Skeletal Muscle Density With Incident Stroke, Myocardial Infarction, and All‐Cause Mortality in Community‐Dwelling 70‐Year‐Old Individuals: A Prospective Cohort Study

2021 ◽  
Author(s):  
Marcel Ballin ◽  
Peter Nordström ◽  
Johan Niklasson ◽  
Anna Nordström
Keyword(s):  
Myocardial Infarction ◽  
Skeletal Muscle ◽  
Adipose Tissue ◽  
Visceral Adipose Tissue ◽  
Community Dwelling ◽  
Health Examination ◽  
Muscle Density ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Visceral Adipose

Background Aging leads to increased visceral adipose tissue (VAT) and reduced skeletal muscle density. To which extent these are associated with the risk of stroke, myocardial infarction (MI), and all‐cause mortality in older adults is unknown. Methods and Results A total of 3294 70‐year‐old individuals (49.6% women) underwent a health examination in Umeå, Sweden, during 2012 to 2018. VAT and muscle density were measured using dual‐energy x‐ray absorptiometry and peripheral quantitative computed tomography. Cases of stroke, MI, and all‐cause mortality were collected through national registers. Cox regressions were used to calculate hazard ratios (HRs) and 95% CIs per SD greater VAT and per SD lower muscle density. During a mean follow‐up of 3.6 years, there were 108 cases of stroke or MI, and 97 deaths. Greater VAT (adjusted HR [aHR], 1.56; 95% CI, 1.09–2.22), but not lower muscle density (aHR, 1.14; 95% CI, 0.97–1.34), was associated with increased risk of stroke or MI. Neither VAT (aHR, 0.95; 95% CI, 0.65–1.41) nor muscle density (aHR, 1.11; 95% CI, 0.92–1.34) was associated with all‐cause mortality. The association of VAT with stroke or MI was only significant in men (aHR, 1.86; 95% CI, 1.19–2.91) but not women (aHR, 0.60; 95% CI, 0.25–1.42) ( P interaction =0.038). Conclusions With the limitation of being an observational study, these findings suggest that VAT is an important obesity‐related predictor of cardiovascular risk in 70‐year‐old men, and by implication, that decreasing VAT may potentially reduce their risk of cardiovascular disease.

Relationship Between Fibrinopeptide A and Fibrinogen/Fibrin Fragment E in Thromboembolism, DIC and Various Non-Thromboembolic Diseases

1987 ◽  
Vol 58 (02) ◽  
pp. 758-763 ◽  
Author(s):  
G Mombelli ◽  
R Monotti ◽  
A Haeberli ◽  
P W Straub
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Liver Cirrhosis ◽  
Healthy Subjects ◽  
Vascular Diseases ◽  
Fibrinopeptide A ◽  
Normal Range ◽  
Collagen Vascular Diseases ◽  
Intravascular Coagulation ◽  
Fibrin Formation

SummaryIncreased fibrinopeptide A (FPA) levels have been reported in various non-thrombotic disorders, including cancer, acute myocardial infarction, liver cirrhosis and collagen vascular diseases. To investigate the significance of these findings, the present study combined the radioimmunoassay of FPA with that of fibrinogen/fibrin degradation fragment E (FgE) in the aforementioned disorders and compared the results with those observed in healthy subjects as well as in patients with thromboembolism and overt disseminated intravascular coagulation (DIC). Mean FPA and FgE in malignancy were 6.3 and 305 ng/ml, in myocardial infarction 5.6 and 98 ng/ml, in liver cirrhosis 2.7 and 132 ng/ml and in collagen vascular diseases 5.6 and 142 ng/ml. All these values were significantly higher than in healthy controls (mean FPA 1.6 ng/ml, mean FgE 49 ng/ml) but significantly lower than in thromboembolism (mean FPA 10.7 ng/ml, mean FgE 639 ng/ ml) and DIC (mean FPA 22.0 ng/ml, mean FgE 1041 ng/ml). The overall correlation between FPA and FgE was highly significant. Elowever, different disorders showed peculiar patterns in FPA, FgE and fibrinogen levels. In malignancy, a definite increase of FPA, FgE and plasma fibrinogen levels was observed. This finding probably indicates a compensated state of (intra- or extravascular) fibrin formation and lysis. Acute myocardial infarction was characterized by a high FPA to FgE ratio, which is interpreted to reflect acute thrombin generation and fibrin formation. FPA in cirrhosis was only marginally elevated with most single values within the normal range, indicating that intravascular coagulation was infrequent and unimportant in quantitative terms.

Abstract 14652: Systolic Blood Pressure Trajectories and Cardiovascular Outcomes in SPRINT

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Charles A German ◽  
Tali Elfassy ◽  
Matthew J Singleton ◽  
Carlos J Rodriguez ◽  
Walter T Ambrosius ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Latent Class ◽  
Stable Group ◽  
Coronary Syndrome ◽  
Average Blood Pressure ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Over Time

Introduction: Blood pressure trajectories have been associated with cardiovascular disease (CVD) in observational studies. It is unclear whether these associations are independent of average blood pressure over time. Methods: We used data from SPRINT to identify systolic blood pressure (SBP) trajectories among a cohort of 8901 participants by incorporating SBP measures during the first 12 months of the trial post randomization. Trajectories were identified using latent class based modeling. Study outcomes included incident CVD, defined as myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death attributable to CVD, and all-cause mortality. Cox proportional hazards models were used to evaluate associations between SBP trajectories and our outcomes of interest. Results: Four distinct SBP trajectories were identified: ‘low decline’ (40%), ‘high decline’ (6%), ‘low stable’ (48%), and ‘high stable’ (5%) (Figure 1). Relative to the low decline group, the low stable group was associated with a 29% increased risk of CVD (HR: 1.29, 95%CI: 1.06-1.57) and the high stable group was associated with a 76% increased risk of all-cause mortality (HR: 1.76, 95%CI: 1.15-2.68) after baseline multivariable adjustment. Relative to the low stable group, the high stable group was associated with a 54% increased risk of all-cause mortality (HR: 1.54, 95%CI: 1.05-2.28). When adjusting for average blood pressure across the 12 month time period, there were no significant differences in outcomes. Conclusion: We identified 4 SBP trajectories using data from SPRINT and found differences in the risk of CVD and all-cause mortality after baseline adjustment. However, there were no differences in the risk of these outcomes after adjusting for average blood pressure over time. These results suggest that the pattern of blood pressure control may not be relevant as long as the target blood pressure is achieved.

Abstract 3739: The Influence of Albuminuria on Mortality in Patients with Stable Coronary Artery Disease

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Scott D Solomon ◽  
Julie Lin ◽  
Caren G Solomon ◽  
Kathleen Jablonski ◽  
Madeline Murguia Rice ◽  
...  
Keyword(s):  
Coronary Disease ◽  
Systolic Function ◽  
Cardiovascular Death ◽  
Creatinine Ratio ◽  
Normal Range ◽  
Albumin Creatinine Ratio ◽  
Cardiovascular Morbidity And Mortality ◽  
Increased Risk ◽  
All Cause Mortality

Background: Patients with chronic kidney disease are at increased risk for cardiovascular morbidity and mortality. We assessed the association between albuminuria and death or cardiovascular events among patients with stable coronary disease. Methods: We studied patients enrolled in the Prevention of Events with an ACE Inhibitor (PEACE) trial, in which patients with chronic stable coronary disease and preserved systolic function were randomized to trandolapril or placebo and followed for a median of 4.8 years. The urinary albumin to creatinine ratio (ACR) assessed in a core laboratory in 2977 patients at baseline and in 1339 patients at follow-up (mean 34 months) was related to estimated glomerular filtration rate (eGFR) and outcomes. Results: The majority of patients (73%) had a baseline albumin/creatinine ratio within the normal range. Independent of the eGFR and other baseline covariates, a higher albumin/creatinine ratio even within the normal range was associated with increased risks for all-cause mortality (p < 0.001) and cardiovascular death (p = 0.01). The effect of trandolapril therapy on outcomes was not significantly modified by the level of albuminuria. Nevertheless, trandolapril therapy was associated with a significantly lower mean follow-up ACR (12.5 ug/mg vs 14.6 ug/mg, p = 0.0002), after adjusting for baseline ACR, time between collections and other covariates. An increase in ACR over time was associated with increased risk of cardiovascular death (HR per log ACR 1.74, 95% confidence intervals 1.08–2.82). Conclusions: Albuminuria, even in low levels within the normal range, is an independent predictor of cardiovascular and all-cause mortality.

scholarly journals Comparison Study Between Local TSH IRMA Kit (CRRT) and Imported TSH IRMA Kit (Riakey, Korea)

2019 ◽  
Vol 4 (2) ◽  
pp. 77
Author(s):  
Gina Mondrida ◽  
Triningsih Triningsih ◽  
Kristina Dwi Purwanti ◽  
Sutari Sutari ◽  
Sri Setyowati ◽  
...  
Keyword(s):  
False Negative ◽  
Thyroid Stimulating Hormone ◽  
The Body ◽  
True Positive ◽  
Comparison Study ◽  
Complex Matrix ◽  
Normal Range ◽  
True Negative ◽  
Immunoassay Technique ◽  
Tsh Levels

<p><em>Thyroid Stimulating Hormone</em> (TSH) is one of hormones that our body need for growth of brains, bones and other tissues and regulate the metabolism in the body. Normal range of TSH for adult is from 0.3 to 5.5 µIU/ml, whereas for baby ranged from 3 to 18 µIU/ml. An Immunoradiometricassay (IRMA) is one of immunoassay technique using radionuclide as the tracer to detect low quantity of analyte. This technique is suitable for determine TSH levels in human blood serum which has complex matrix and various concentration. The Center for Radioisotope and Radiopharmaceutical Technology (CRRT)-BATAN has developed a reagent of TSH IRMA kit. The aim of this research is to compare between local TSH IRMA kit (CRRT-BATAN) and imported TSH IRMA kit (Riakey, Korea) toward 110 adult samples obtained from PTKMR - BATAN. The results showed 97 samples as true negative, 5 samples as true positive, 1 sample as false negative and 7 samples false positive. The comparison study gave diagnostic sensitivity as much as 83.33 %, diagnostic spesificity as much as 93.27 % and accuracy as much as 92.72 %.</p>

Abstract 2125: P Wave Morphology Is a Predictor of Poor Cardiac Outcome and Death in MADIT II Patients

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Fredrik Holmqvist ◽  
Pyotr G Platonov ◽  
Scott McNitt ◽  
Slava Polonsky ◽  
Jonas Carlson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Death ◽  
P Wave ◽  
Wave Duration ◽  
P Wave Duration ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Wave Morphology ◽  
Cardiac Outcome ◽  
Madit Ii

The objective of the present study was to non-invasively analyse atrial electrophysiology to identify markers associated with increased risk of mortality and deterioration of heart failure in a high-risk population with advanced CHF and a history of acute myocardial infarction. Patients included in MADIT II with sinus rhythm at baseline were studied (n=802). Unfiltered and bandpass filtered signal-averaged P waves were analyzed to determine orthogonal P wave morphology, P wave duration and RMS20. The association between P wave parameters and data on the clinical course and cardiac events during a mean follow-up of 20 months was analyzed. P wave duration was 139±23 ms and the RMS20 was 1.9±1.1 μV. None of these parameters were significantly associated with poor cardiac outcome. Differences in P wave morphology were independently predictive of non-sudden cardiac death (HR 2.66; 95% CI 1.41–5.04, P=0.0027). In addition, in univariate analyses differences in P wave morphology were found to be associated with an increased risk of all-cause mortality (HR 1.35; 95%CI 1.01–1.81, P=0.042) and cardiac death (HR 1.54; 95%CI 1.10 –2.16, P=0.011) (figure ) In the present study the value of analyzing the P wave morphology in patients with previous myocardial infarction and CHF is demonstrated. Changes in P wave morphology were shown to be independently predictive of increased risk of non-sudden cardiac death. Furthermore, statistically significant associations between P wave morphology changes and all-cause mortality, cardiac death and CHF hospitalization was demonstrated.

scholarly journals Prevalence of Subclinical Hypothyroidism among Patients with Acute Myocardial Infarction

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Okuyan Ertugrul ◽  
Uslu Ahmet ◽  
Enhos Asim ◽  
Hepgul E. Gulcin ◽  
Ayca Burak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Subclinical Hypothyroidism ◽  
Large Scale ◽  
Thyroid Stimulating Hormone ◽  
Free T4 ◽  
Upper Limit ◽  
St Elevation ◽  
Elevation Acute Myocardial Infarction ◽  
Tsh Levels

Introduction. Subclinical hypothyroidism (SCH) is defined as a serum thyroid-stimulating hormone (TSH) level above the upper limit of normal despite normal levels of serum free thyroxine. There is growing evidence that SCH is associated with increased cardiovascular risk. We tried to investigate prevalence of SCH in acute myocardial infarction patients. Methods and Results. We evaluate free T3, free T4, and TSH levels of 604 patients (age 58.4) retrospectively, who have been admitted to the coronary intensive care unit between years 2004–2009 with the diagnosis of ST elevation (STEMI) or non-ST elevation acute myocardial infarction (NSTEMI). Mild subclinical hypothyroidism (TSH 4.5 to 9.9 mU/l) was present in 54 (8.94%) participants and severe subclinical hypothyroidism (TSH 10.0 to 19.9 mU/l) in 11 (1.82%). So 65 patients (10.76%) had TSH levels between 4.5 and 20. Conclusions. In conclusion, 65 patients (10.76%) had TSH levels between 4.5 and 20 in our study, and it is a considerable amount. Large-scale studies are needed to clarify the effects of SCH on myocardial infarction both on etiologic and prognostic grounds.

D-dimer and the incidence of heart failure and mortality after acute myocardial infarction

Heart ◽  
2020 ◽  
pp. heartjnl-2020-316880 ◽  
Author(s):  
Xiaoyuan Zhang ◽  
Shanjie Wang ◽  
Jinxin Liu ◽  
Yini Wang ◽  
Hengxuan Cai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Plaque Rupture ◽  
Risk Of Death ◽  
Increased Risk ◽  
Clinical Covariates ◽  
All Cause Mortality ◽  
D Dimer

ObjectiveD-dimer might serve as a marker of thrombogenesis and a hypercoagulable state following plaque rupture. Few studies explore the association between baseline D-dimer levels and the incidence of heart failure (HF), all-cause mortality in an acute myocardial infarction (AMI) population. We aimed to explore this association.MethodsWe enrolled 4504 consecutive patients with AMI with complete data in a prospective cohort study and explored the association of plasma D-dimer levels on admission and the incidence of HF, all-cause mortality.ResultsOver a median follow-up of 1 year, 1112 (24.7%) patients developed in-hospital HF, 542 (16.7%) patients developed HF after hospitalisation and 233 (7.1%) patients died. After full adjustments for other relevant clinical covariates, patients with D-dimer values in quartile 3 (Q3) had 1.51 times (95% CI 1.12 to 2.04) and in Q4 had 1.49 times (95% CI 1.09 to 2.04) as high as the risk of HF after hospitalisation compared with patients in Q1. Patients with D-dimer values in Q4 had more than a twofold (HR 2.34; 95% CI 1.33 to 4.13) increased risk of death compared with patients in Q1 (p<0.001). But there was no association between D-dimer levels and in-hospital HF in the adjusted models.ConclusionsD-dimer was found to be associated with the incidence of HF after hospitalisation and all-cause mortality in patients with AMI.

scholarly journals Estimating the proportion of coronavirus disease 2019 (COVID-19) cases among households in France: a cross-sectional study based on individuals with myocardial infarction history

2020 ◽  
Author(s):  
Laurie Fraticelli ◽  
Julie Freyssenge ◽  
Clément Claustre ◽  
Mikaël Martinez ◽  
Abdesslam Redjaline ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Telephone Survey ◽  
Cross Sectional Study ◽  
Severe Form ◽  
Infection Rates ◽  
Cross Sectional ◽  
The Past ◽  
Health Measures ◽  
Increased Risk ◽  
All Cause Mortality

AbstractBackgroundPrevious studies have identified that adults with cardiovascular diseases were disproportionately associated with a significantly increased risk of a severe form of COVID-19 and all-cause mortality. We aimed to describe the diagnosed COVID-19 cases and to estimate the symptomatic and asymptomatic suspected cases among individuals with pre-existing myocardial infarction myocardial infarction and their relatives in lockdown period. Methods: We conducted a two-week cross-sectional telephone survey, from May 4 to May 15, 2020, including all households with at least one individual with pre-existing cardiovascular disease in the past two years. We defined a suspected COVID-19 case when living with at least one individual tested positive to COVID-19, or when an individual has been in contact with a suspected or confirmed case since the March 1rst, or when a relative from the same house has been hospitalized or deceased for COVID-19.ResultsWe observed high rates of compliance with health measures during the lockdown period, regardless of age or risk factors. Among individuals with myocardial infarction history, two were COVID-19 confirmed, 13·37% were suspected (94/703) of whom 70·21% (66/94) asymptomatic.ConclusionsIndividuals with myocardial infarction history presented different symptoms association with more respiratory signs. This population, which is older and associated with more comorbidities, is exposed to a high risk of complication in the event of contamination. Infection rates are relevant to adjusting the management of emergency departments in our region.

scholarly journals The Association of Meat Intake With All-Cause Mortality and Acute Myocardial Infarction Is Age-Dependent in Patients With Stable Angina Pectoris

2021 ◽  
Vol 8 ◽  
Author(s):  
Åslaug O. Matre ◽  
Anthea Van Parys ◽  
Thomas Olsen ◽  
Teresa R. Haugsgjerd ◽  
Carl M. Baravelli ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Angina Pectoris ◽  
Stable Angina ◽  
Stable Angina Pectoris ◽  
Meat Intake ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Total Meat

Background: Red and processed meat intake have been associated with increased risk of morbidity and mortality, and a restricted intake is encouraged in patients with cardiovascular disease. However, evidence on the association between total meat intake and clinical outcomes in this patient group is lacking.Objectives: To investigate the association between total meat intake and risk of all-cause mortality, acute myocardial infarction, cancer, and gastrointestinal cancer in patients with stable angina pectoris. We also investigated whether age modified these associations.Materials and Methods: This prospective cohort study consisted of 1,929 patients (80% male, mean age 62 years) with stable angina pectoris from the Western Norway B-Vitamin Intervention Trial. Dietary assessment was performed by the administration of a semi-quantitative food frequency questionnaire. Cox proportional hazards models were used to investigate the association between a relative increase in total meat intake and the outcomes of interest.Results: The association per 50 g/1,000 kcal higher intake of total meat with morbidity and mortality were generally inconclusive but indicated an increased risk of acute myocardial infarction [HR: 1.26 (95% CI: 0.98, 1.61)] and gastrointestinal cancer [1.23 (0.70, 2.16)]. However, we observed a clear effect modification by age, where total meat intake was associated with an increased risk of mortality and acute myocardial infarction among younger individuals, but an attenuation, and even reversal of the risk association with increasing age.Conclusion: Our findings support the current dietary guidelines emphasizing a restricted meat intake in cardiovascular disease patients but highlights the need for further research on the association between meat intake and health outcomes in elderly populations. Future studies should investigate different types of meat separately in other CVD-cohorts, in different age-groups, as well as in the general population.

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