Dataset Information

Prognostic Value of Normal Thyroid Stimulating Hormone in Long-Term Mortality in Patients With STEMI.

ABSTRACT:

Background

Although within the normal range, thyroid stimulating hormone (TSH) levels are associated with cardio-metabolic disorders and have an effect on the cardiovascular system. The aim of our study was to assess the prognostic value of normal TSH on long-term mortality in patients with ST-segment elevation myocardial infarction (STEMI).

Methods

Consecutive STEMI patients who had a TSH level within the normal range (0.55-4.78 μIU/ml) were enrolled from November 2013 to December 2018. Patients were stratified into three groups depending on the tertile of TSH level, and all-cause mortality and cardiac death were compared. TSH concentrations associated with risk of all-cause mortality were evaluated in a continuous scale (restricted cubic splines) and the Cox proportional hazards regression model.

Results

A total of 1,203 patients with STEMI were eligible for analysis. During a median follow-up of 39 months, patients in the 3rd tertile group had higher all-cause mortality (20.1% vs. 12.2% and 14.3%, p = 0.006) and cardiac death (15.4% vs. 7.7% and 12.3%, p = 0.001) as compared to the 1st and 2nd tertile groups. The Cox proportional hazards model showed that TSH was an independent predictor on long-term all-cause mortality (HR: 1.248, 95% CI: 1.046-1.490, p = 0.014). However, subgroup analysis indicated that TSH (HR: 1.313, 95% CI: 1.063-1.623, p = 0.012) was only significantly associated with long-term all-cause mortality in the patients without emergency reperfusion therapy. Restricted cubic spline analyses showed a linear relationship between TSH concentrations and all-cause mortality (P for non-linearity = 0.659).

Conclusions

A Higher TSH level - even in a normal range is associated with long-term mortality in patients with STEMI, proposing an additional indication to identify STEMI patients with poor prognosis.

SUBMITTER: Sun L

PROVIDER: S-EPMC8902238 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Prognostic Value of Normal Thyroid Stimulating Hormone in Long-Term Mortality in Patients With STEMI.

Sun Lijie L Xiao Keling K Miao Zupei Z Zhang Yinghua Y Si Jin J Shi Ning N Zhang Haoyu H Zhao Ting T Li Jing J

Frontiers in endocrinology 20220222

<h4>Background</h4>Although within the normal range, thyroid stimulating hormone (TSH) levels are associated with cardio-metabolic disorders and have an effect on the cardiovascular system. The aim of our study was to assess the prognostic value of normal TSH on long-term mortality in patients with ST-segment elevation myocardial infarction (STEMI).<h4>Methods</h4>Consecutive STEMI patients who had a TSH level within the normal range (0.55-4.78 μIU/ml) were enrolled from November 2013 to Decembe ...[more]

PMID: 35273563

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Project description:BackgroundThe bioassay of thyroid-stimulating immunoglobulin was reported to have a similar performance to the commonly used thyroid-stimulating hormone binding inhibition assay, also known as thyroid receptor antibody assay. The normal reference range of thyroid receptor antibody levels indicates the withdrawal of anti-thyroid drugs in the recent clinical guidelines.MethodsA prospective, longitudinal observational study was conducted to evaluate the prognostic value of thyroid-stimulating immunoglobulin in patients with Graves' disease.ResultsA total of 77 patients with Graves' disease treated with anti-thyroid drugs were in a continuous follow-up until 1 year after anti-thyroid drugs discontinuation. Commercial kits of thyroid-stimulating immunoglobulin and M22-thyroid-stimulating hormone binding inhibition assay were used and compared. Thyroid-stimulating immunoglobulin was all negative in healthy controls, Hashimoto thyroiditis, and subacute thyroiditis. Thyroid-stimulating immunoglobulin value was highest in untreated patients with Graves' disease (p < 0.001). Under anti-thyroid drugs treatment, thyroid-stimulating immunoglobulin value decreased gradually. A total of 21 patients had positive thyroid-stimulating immunoglobulin at the end of treatment. According to clinical fate of patients with Graves' disease after withdrawal of anti-thyroid drugs, thyroid-stimulating immunoglobulin value and positivity in patients with relapse were significantly higher than that reported in patients with remission (p = 0.001, p < 0.001). After adjustment for age, gender, initial thyroid receptor antibody, initial thyroid-stimulating immunoglobulin, and thyroid receptor antibody at the end of treatment, the odds ratio of positive thyroid-stimulating immunoglobulin for the risk of relapse was 33.271 (95% confidence interval: 4.741-233.458, p < 0.001) and odds ratio of quantitative thyroid-stimulating immunoglobulin was 1.009 (95% confidence interval: 1.002-1.015, p < 0.001).ConclusionThyroid-stimulating immunoglobulin is a good predictor of relapse in patients with Graves' disease treated with anti-thyroid drugs. It might be safer to discontinue anti-thyroid drugs when thyroid-stimulating immunoglobulin and thyroid receptor antibody were both negative.

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Dataset Information

Prognostic Value of Normal Thyroid Stimulating Hormone in Long-Term Mortality in Patients With STEMI.

Background

Methods

Results

Conclusions

Publications

Prognostic Value of Normal Thyroid Stimulating Hormone in Long-Term Mortality in Patients With STEMI.

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