期刊
INTERNATIONAL JOURNAL OF GENERAL MEDICINE
卷 14, 期 -, 页码 6295-6303出版社
DOVE MEDICAL PRESS LTD
DOI: 10.2147/IJGM.S333322
关键词
acute myocardial infarction; thyroid hormone; thyroid-stimulating hormone; STEMI; TSH
资金
- National Key R&D Program of China [2018YFC1311400, 2018YFC1311404]
In patients with acute ST segment elevation myocardial infarction, admission thyroid-stimulating hormone levels beyond the normal range (TSH >3.5 mIU/L) are associated with worse long-term outcomes, while high-normal TSH or reduced TSH do not impact long-term prognosis.
Objective: Thyroid hormones are closely related to the cardiovascular system. Our study aimed to explore the impact of admission thyroid-stimulating hormone (TSH) levels on long-term outcomes in patients with acute ST segment elevation myocardial infarction (STEMI) by detailed stratifications of TSH. Methods: Consecutive STEMI patients admitted to our hospital were divided into four groups: Group 1 (TSH <0.35 mIU/L), Group 2 (TSH 0.35-1.0 mIU/L), Group 3 (TSH 1.0-3.5 mIU/L), and Group 4 (TSH >3.5 mIU/L). The primary endpoint was all-cause mortality during follow-up, and the median follow-up was 2.5 years. Cox proportional hazard regres-sion models were performed to identify the prognostic value of TSH. Results: A total of 1186 patients were included. Group 4 was presented with higher systolic and diastolic blood pressure (all P < 0.001), and Group 1 had more patients complicated by heart failure (Killip class >I, P = 0.014). During follow-up, 138 deaths occurred. Patients in Group 4 had the worst long-term outcomes (P < 0.001). The cumulative survival in Group 4 was remarkably lower (Log rank P < 0.001), whereas the other three groups were comparable (Log rank P = 0.365). Through Cox regression analysis, only TSH >3.5 mIU/L was identified as an independent risk factor for long-term mortality after STEMI. Conclusion: Only TSH elevation beyond the normal range was associated with worse long-term prognosis in STEMI patients, while high-normal TSH or reduced TSH did not alter long-term prognosis of STEMI patients. TSH >3.5 mIU/L was an independent risk factor for long-term mortality in STEMI.
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