EVALUATION OF THYROID PROFILE AND ITS PROGNOSTIC VALUE IN PATIENTS OF ACUTE CORONARY SYNDROME

Authors

  • Bhavik Thacker Department of General Medicine, GMCH, Udaipur, Rajasthan, India.
  • Lalit Shrimali Department of General Medicine, GMCH, Udaipur, Rajasthan, India.
  • Abhishek Padhiar Department of General Medicine, GMCH, Udaipur, Rajasthan, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i10.47967

Keywords:

Coronary artery disease, Acute coronary syndromes, ST-segment elevation myocardial infarction, Non-ST-segment elevation myocardial infarction, Myocardial infarction

Abstract

Objective: The objective of the study is to study the association of thyroid dysfunction with acute coronary syndrome (ACS), its complications and duration of hospital stay.

Methods: This prospective comparative study was done on 100 patients divided equally into ACS patients with control (normal thyroid function) and ACS patients with thyroid dysfunction admitted in a tertiary care center, Udaipur, Rajasthan with ACS during the period of February 2021–July 2022. We studied the prevalence, prognostic factor of thyroid hormone in these patients.

Results: The mean ejection fraction of the control group was 51.16±11.72%, of hypothyroid group was 49.00±13.55% and of hyperthyroid group was 51.12±13.78%. 29 cases of cardiac failures, 38 cases of arrhythmias, and 32 cases of major adverse cardiac events were observed. 56% of patients required thrombolysis, out of which 67.86% were from the subclinical hypothyroid group. The mean hospital stay in control group was 4.53±1.55, in hypothyroid group was 5.27±1.84 and in hyperthyroid group was 7.00±1.92.18% mortality.

Conclusion: Patients with acute myocardial infarction, initially develop alteration in thyroid hormone levels, which is possibly a compensatory mechanism to reduce the metabolic demand of the heart, by reducing myocardium contraction and cardiac output but may cause cardiac failure and higher rates of cardiovascular complications like arrhythmias and death in some of the patients. Thyroid dysfunctions in patients with ACS may also need a longer duration of intensive care and close monitoring during follow-up.

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Author Biographies

Bhavik Thacker, Department of General Medicine, GMCH, Udaipur, Rajasthan, India.

Resident, Department of General Medicine

Geetanjali Medical College and Hospital, Udaipur

Lalit Shrimali, Department of General Medicine, GMCH, Udaipur, Rajasthan, India.

Professor, Department of General Medicine, GMCH, Udaipur

References

Arambam P, Kaul U, Ranjan P, Janardhanan R. Prognostic implications of thyroid hormone alterations in acute coronary syndrome-a systematic review. Indian Heart J 2020;73:143-8.

Koutsoukis A, Kanakakis I. Challenges and unanswered questions in STEMI management. Hellenic J Cardiol 2019;60:211-5. doi: 10.1016/j. hjc.2019.01.001, PMID 30639352

Burtis CA, Bruns DE. Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics-E-Book. Amsterdam: Elsevier Health Sciences; 2014.

Centers for Disease Control and Prevention (CDC). Smoking-attributable mortality, years of potential life lost, and productivity losses--United States. JAMA 2009;301:593.

Lavanya N. A Study on Thyroid Profile and its Prognostic Value in Patients Presenting with ST Elevation Myocardial Infarction [Doctoral Dissertation]. Madurai: Madurai Medical College.

Lymvaios I, Mourouzis I, Cokkinos DV, Dimopoulos MA, Toumanidis ST, Pantos C. Thyroid hormone and recovery of cardiac function in patients with acute myocardial infarction: A strong association? Eur J Endocrinol 2011;165:107-14. doi: 10.1530/EJE-11- 0062, PMID 21490121

Khalil OA, Awad M, Selim FO, Sadek AE, Fawzy MS. Thyroid dysfunction in patients with metabolic syndrome in medical ICU of Zagazig university hospitals. Benha Med J 2018;35:350-5. doi: 10.4103/ bmfj.bmfj_31_18

Paudel N, Alurkar VM, Kafle R, Maskey A, Sapkota S. Thyroid profile as a marker of poor prognostic factor in patients with acute coronary syndrome: A tertiary care hospital based observational study. Nepal Heart J 2018;15:39-41. doi: 10.3126/njh.v15i1.19715

Mukherjee S, Datta S, Mandal SC. Prevalence of subclinical hypothyroidism in acute coronary syndrome in nondiabetics: Detailed analysis from consecutive 1100 patients from Eastern India. J Thyroid Res 2018;2018:9030185. doi: 10.1155/2018/9030185, PMID 30254730

Ozcan KS, Osmonov D, Toprak E, Güngör B, Tatlısu A, Ekmekçi A, et al. Sick euthyroid syndrome is associated with poor prognosis in patients with ST segment elevation myocardial infarction undergoing primary percutaneous intervention. Cardiol J 2014;21:238-44.

Published

07-10-2023

How to Cite

Thacker, B., L. Shrimali, and A. Padhiar. “EVALUATION OF THYROID PROFILE AND ITS PROGNOSTIC VALUE IN PATIENTS OF ACUTE CORONARY SYNDROME”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 10, Oct. 2023, pp. 163-6, doi:10.22159/ajpcr.2023.v16i10.47967.

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