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Observational Study
. 2018 Feb;110(2):113-118.
doi: 10.5935/abc.20180019.

Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?

[Article in English, Portuguese]
Alexandre de Matos Soeiro  1 , Victor Arrais Araújo  1 , Júlia Pitombo Vella  1 , Aline Siqueira Bossa  1 , Bruno Biselli  1 , Tatiana de Carvalho Andreucci Torres Leal  1 , Maria Carolina Feres de Almeida Soeiro  1 , Carlos V Serrano Jr  1 , Christian Mueller  2 , Mucio Tavares de Oliveira Junior  1
Affiliations
Observational Study

Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?

[Article in English, Portuguese]
Alexandre de Matos Soeiro et al. Arq Bras Cardiol. 2018 Feb.

Abstract

Background: Some small studies have related higher levels of thyrotropin (TSH) to potentially worse prognosis in acute coronary syndromes. However, this relationship remains uncertain.

Objective: To analyze the outcomes of patients with acute coronary syndromes in relation to the value of TSH at admission.

Methods: Observational and retrospective study with 505 patients (446 in group I [TSH ≤ 4 mIU/L] and 59 in group II [TSH > 4 mIU/L]) with acute coronary syndromes between May 2010 and May 2014. We obtained data about comorbidities and the medications used at the hospital. The primary endpoint was in-hospital all-cause death. The secondary endpoint included combined events (death, non-fatal unstable angina or myocardial infarction, cardiogenic shock, bleeding and stroke). Comparisons between groups were made by one-way ANOVA and chi-square test. Multivariate analysis was determined by logistic regression. Analyses were considered significant when p < 0.05.

Results: Significant differences between groups I and II were observed regarding the use of enoxaparin (75.2% vs. 57.63%, p = 0.02) and statins (84.08% vs. 71.19%, p < 0.0001), previous stroke (5.83% vs. 15.25%, p = 0.007), combined events (14.80% vs. 27.12%, OR = 3.05, p = 0.004), cardiogenic shock (4.77% vs. 6.05%, OR = 4.77, p = 0.02) and bleeding (12.09% vs. 15.25%, OR = 3.36, p = 0.012).

Conclusions: In patients with acute coronary syndromes and TSH > 4 mIU/L at admission, worse prognosis was observed, with higher incidences of in-hospital combined events, cardiogenic shock and bleeding.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Classification of ACS according to TSH levels. NSTEMI: Non-ST-elevation myocardial infarction; STEMI: ST-elevation myocardial infarction; TSH: thyrotropin.
See this image and copyright information in PMC

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