The Effect of Thyroid Stimulating Hormone Level Within the Reference Range on In-Hospital and Short-Term Prognosis in Acute Coronary Syndrome Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subject Selection
2.2. Collection of Data
2.3. Statistical Analysis
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variables | Low Tertile (n = 209) | Mid Tertile (n = 211) | High Tertile (n = 209) | p Value | |
---|---|---|---|---|---|
Age (year) | 63.00 ± 11.26 | 62.53 ± 13.39 | 64.76 ± 12.90 | 0.179 | |
Gender | Male | 163 (35.10) | 164 (35.30) | 138 (29.70) | 0.006 * |
Female | 46 (28.00) | 47 (28.70) | 71 (43.80) | ||
BMI, kg/cm2 | 27.40 ± 2.83 | 27.40 ± 2.90 | 27.63 ± 3.79 | 0.874 | |
Smoking | 113 (33.70) | 115 (34.30) | 107 (31.90) | 0.562 | |
Hypertension | 113 (30.80) | 125 (34.10) | 129 (35.10) | 0.269 | |
Diabetes mellitus | 77 (37.70) | 65 (31.90) | 62 (30.40) | 0.242 | |
Hyperlipidemia | 21 (28.40) | 30 (40.50) | 23 (31.10) | 0.380 | |
Heart failure | 10 (31.20) | 9 (28.10) | 13 (40.60) | 0.641 | |
Cancer | 22 (40.00) | 16 (29.10) | 17 (30.90) | 0.526 | |
CAD | 74 (34.10) | 74 (34.10) | 69 (31.80) | 0.856 | |
CVA | 18 (40.90) | 12 (27.30) | 14 (31.80) | 0.491 | |
PAD | 3 (37.50) | 2 (25.00) | 3 (37.50) | 0.827 | |
CKD | 16 (37.20) | 11 (25.60) | 16 (37.20) | 0.519 | |
COPD | 14 (30.40) | 21 (45.70) | 11 (23.90) | 0.167 | |
AF | 11 (31.40) | 13 (37.10) | 11 (31.40) | 0.898 | |
SBP, mmHg | 121.35 ± 18.00 | 119.32 ± 15.48 | 121.07 ± 17.54 | 0.458 | |
DBP, mmHg | 72.98 ± 13.02 | 72.60 ± 11.42 | 74.05 ± 10.47 | 0.458 | |
ACS subtypes | UA or NSTEMI | 125 (33.70) | 121 (32.60) | 125 (33.70) | 0.839 |
STEMI | 84 (32.60) | 90 (34.90) | 84 (32.60) |
Laboratory Analysis | Low Tertil (n = 209) | Mid Tertil (n = 211) | High Tertil (n = 209) | p Value |
---|---|---|---|---|
WBC count, 109/L | 11.10 (8.60–14.10) | 10.00 (8.40–13.17) | 10.20 (8.30–13.00) | 0.095 |
Lymphocyte, 109/L | 2.00 (1.40–2.70) | 2.10 (1.50–2.70) | 2.00 (1.30–3.00) | 0.864 |
Hemoglobin, g/dL | 13.44 ± 2.32 | 13.58 ± 2.06 | 13.07 ± 2.22 | 0.048 * |
CRP | 0.70 (0.30–2.02) | 0.54 (0.30–1.30) | 0.70 (0.30–2.74) | 0.073 |
Glucose, mg/dL | 129 (108–192) | 129 (103–172) | 128 (108.5–172) | 0.653 |
GFR, mL/min | 93 (74.75–107.25) | 88.5 (65.75–111) | 81.5 (64–106.25) | 0.054 |
TG, mg/dL | 122 (86.25–171.75) | 131 (90.50–205) | 131 (100–176.75) | 0.340 |
TC, mg/dL | 184.14 ± 49.23 | 184.00 ± 48.09 | 183.83 ± 47.67 | 0.998 |
LDL-C, mg/dL | 119.61 ± 37.31 | 117.38 ± 34.86 | 119.74 ± 35.51 | 0.755 |
Total bilirubin, mg/dL | 0.50 (0.30–0.70) | 0.50 (0.30–0.70) | 0.50 (0.30–0.875) | 0.835 |
ALT, IU/L | 21 (17–32) | 21 (14–28.5) | 22 (14–31) | 0.074 |
AST, IU/L | 36 (25–73) | 30 (23–50) | 34 (24–57) | 0.026 * |
INR | 1.13 ± 0.27 | 1.12 ± 0.31 | 1.16 ± 0.28 | 0.290 |
APTT | 29 (26.625–34) | 29.05 (26.92–32.57) | 30 (27.05–34) | 0.629 |
Albumin | 3.68 ± 0.54 | 3.75 ± 0.52 | 3.60 ± 0.52 | 0.036 * |
Sodium | 137.43 ± 3.45 | 137.68 ± 3.17 | 137.41 ± 3.60 | 0.662 |
Potassium | 4.46 ± 0.56 | 4.39 ± 0.52 | 4.36 ± 0.64 | 0.195 |
Calcium | 8.97 ± 0.64 | 9.04 ± 0.77 | 8.90 ± 0.84 | 0.475 |
Magnesium | 1.93 ± 0.40 | 1.94 ± 0.31 | 1.97 ± 0.34 | 0.860 |
FT3 | 2.97 ± 0.49 | 2.95 ± 0.61 | 2.97 ± 0.57 | 0.949 |
FT4 | 0.90 (0.8–1.0825) | 0.90 (0.8–1.05) | 0.90 (0.8–1.09) | 0.896 |
TSH | 0.60 ± 0.19 | 1.25 ± 0.20 | 2.61 ± 0.93 | <0.001* |
LVEF, % | 50.86 ± 9.00 | 52.52 ± 9.33 | 49.81 ± 10.65 | 0.020 * |
Extend of CAD * | ||||
One-vessel disese | 76 (39.2) | 66 (34) | 52 (26.8) | 0.024 * |
Multivessel disease | 109 (29.1) | 129 (34.5) | 136 (36.4) |
In-Hospital Medication | Low Tertil (n = 209) | Mid Tertile (n = 211) | High Tertil (n = 209) | p Value |
---|---|---|---|---|
ASA | 200 (32.60) | 208 (33.90) | 205 (33.40) | 0.134 |
Clopidogrel | 161 (33.40) | 161 (33.40) | 160 (33.20) | 0.984 |
Ticagrelor | 33 (29.70) | 39 (35.10) | 39 (35.10) | 0.689 |
Prasugrel | 5 (41.70) | 5 (41.70) | 2 (16.70) | 0.511 |
Beta-blockers | 151 (31.90) | 167 (35.20) | 156 (32.90) | 0.249 |
CCB (dihydropyridine) | 11 (27.50) | 17 (42.50) | 12 (30.00) | 0.455 |
ACEI | 125 (32.90) | 134 (35.30) | 121 (31.80) | 0.519 |
ARB | 3 (50.00) | 3 (50.00) | 0 (0.00) | 0.256 |
Heparin (all class) | 194 (33.80) | 193 (33.60) | 187 (32.60) | 0.475 |
Statins | 180 (32.80) | 189 (34.40) | 180 (32.80) | 0.472 |
Furosemid | 22 (39.30) | 13 (23.20) | 21 (37.50) | 0.226 |
Spironolactone | 9 (27.30) | 11 (33.30) | 13 (39.40) | 0.680 |
Nitrates | 45 (36.00) | 37 (29.60) | 43 (34.40) | 0.563 |
Inotropic agents | 14 (26.40) | 17 (32.10) | 14 (26.40) | 0.361 |
In-Hospital Period | Low Tertile (n = 209) | Mid Tertile (n = 211) | High Tertile (n = 209) | p Value |
---|---|---|---|---|
CICU LOS, days | 3 (2–4) | 3 (2–4) | 3 (2–5) | 0.221 |
Total LOS, days | 6 (4–9) | 6 (5–8) | 6 (4–9) | 0.844 |
In-hospital event | 52 (32.30) | 43 (26.70) | 66 (41.00) | 0.03 * |
Major bleeding | 5 (20.00) | 4 (16.00) | 16 (64.00) | 0.005 * |
In-hospital transfusion | 8 (21.10) | 14 (36.80) | 16 (42.10) | 0.235 |
Re-infarct | 1 (50.00) | 0 (0.00) | 1 (50.00) | 0.553 |
VT/VF | 7 (41.20) | 2 (11.80) | 8 (47.10) | 0.149 |
Heart failure | 6 (40.00) | 3 (20.00) | 6 (40.00) | 0.531 |
New onset AF | 8 (34.80) | 6 (26.10) | 9 (39.10) | 0.718 |
Acute renal failure | 8 (23.30) | 6 (30.00) | 9 (46.70) | 0.252 |
CPA | 17 (35.40) | 13 (27.10) | 18 (37.50) | 0.613 |
Mechanic complications | 4 (44.40) | 3 (33.30) | 2 (22.20) | 0.783 |
Infection | 15 (27.30) | 14 (25.50) | 26 (47.30) | 0.067 |
In-hospital mortality | 5 (12.20) | 12 (29.30) | 24 (58.50) | <0.001 * |
Inotropic drug requirement | 12 (25.00) | 15 (31.20) | 21 (43.80) | 0.238 |
Stroke | 1 (50.00) | 1 (50.00) | 0 (0.00) | 1.000 |
Follow-up period (6 months) | ||||
Total event | 37 (34.60) | 23 (21.50) | 47 (43.90) | 0.006 * |
Mortality | 13 (28.90) | 9 (20.00) | 23 (51.10) | 0.022 * |
Re-hospitalization | 12 (28.60) | 10 (23.80) | 20 (47.60) | 0.112 |
Re-infarct | 22 (33.30) | 18 (27.30) | 26 (39.40) | 0.425 |
Cumulative mortality | 18 (20.90) | 21 (24.40) | 47 (54.70) | <0.001 * |
Variable | In Hospital Mortality | Follow-Up Mortality | Cumulative Mortality | |||
---|---|---|---|---|---|---|
OR (95% CI) | p Value | OR (95% CI) | p Value | OR (95% CI) | p Value | |
TSH (mid) | 2.542 | 0.356 | 3.614 | 0.146 | 2.965 | 0.101 |
(0.351–18.429) | (0.639–20.428) | (0.808–10.883) | ||||
TSH (high) | 5.218 | 0.09 | 5.867 | 0.040 * | 6.307 | 0.005 * |
(0.773–35.211) | (1.083–31.774) | (1.769–22.480) | ||||
Age | 1.001 | 0.969 | 0.989 | 0.669 | 0.993 | 0.735 |
(0.946–1.059) | (0.941–1.040) | (0.954–1.033) | ||||
Gender (Male) | 1.178 | 0.837 | 1.104 | 0.88 | 1.18 | 0.762 |
(0.249–5.581) | (0.305–4.000) | (0.405–3.434) | ||||
DM | 0.906 | 0.883 | 4.148 | 0.021 * | 2.398 | 0.069 |
(0.245–3.357) | (1.243–13.841) | (0.934–6.156) | ||||
Smoking | 0.662 | 0.528 | 1.044 | 0.943 | 0.761 | 0.559 |
(0.184–2.383) | (0.324–3.366) | (0.304–1.904) | ||||
CAD | 2.451 | 0.171 | 0.587 | 0.391 | 1.126 | 0.803 |
(0.680–8.839) | (0.174–1.982) | (0.444–2.855) | ||||
HL | 0.885 | 0.901 | 1.136 | 0.873 | 1.127 | 0.859 |
(0.128–6.121) | (0.239–5.386) | (0.302–4.212) | ||||
LVEF | 0.942 | 0.043 * | 0.976 | 0.409 | 0.956 | 0.043 * |
(0.890–0.998) | (0.922–1.034) | (0.916–0.999) | ||||
Multivessel | 0.624 | 0.499 | 0.379 | 0.097 | 0.424 | 0.072 |
(0.159–2.446) | (0.121–1.192) | (0.167–1.080) | ||||
HGB | 1.095 | 0.546 | 0.93 | 0.578 | 0.998 | 0.983 |
(0.815–1.471) | (0.719–1.202) | (0.815–1.222) | ||||
GFR | 0.992 | 0.445 | 1 | 0.919 | 0.997 | 0.563 |
(0.973–1.012) | (0.991–1.008) | (0.987–1.007) | ||||
AST | 1.003 | 0.397 | 0.998 | 0.657 | 1.001 | 0.705 |
(0.973–1.012) | (0.989–1.007) | (0.996–1.007) | ||||
Albumin | 0.267 | 0.052 | 0.35 | 0.065 | 0.252 | 0.004 * |
(0.070–1.014) | (0.115–1.069) | (0.099–0.642) | ||||
Major Bleeding | 0.448 | 0.523 | 0.378 | 0.426 | 0.333 | 0.25 |
(0.038–5.267) | (0.035–4.140) | (0.051–2.166) | ||||
HT | 0.739 | 0.681 | 1.246 | 0.754 | 0.943 | 0.912 |
(0.175–3.120) | (0.315–4.929) | (0.330–2.692) |
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Gürdoğan, M.; Altay, S.; Korkmaz, S.; Kaya, Ç.; Zeybey, U.; Ebik, M.; Demir, M. The Effect of Thyroid Stimulating Hormone Level Within the Reference Range on In-Hospital and Short-Term Prognosis in Acute Coronary Syndrome Patients. Medicina 2019, 55, 175. https://doi.org/10.3390/medicina55050175
Gürdoğan M, Altay S, Korkmaz S, Kaya Ç, Zeybey U, Ebik M, Demir M. The Effect of Thyroid Stimulating Hormone Level Within the Reference Range on In-Hospital and Short-Term Prognosis in Acute Coronary Syndrome Patients. Medicina. 2019; 55(5):175. https://doi.org/10.3390/medicina55050175
Chicago/Turabian StyleGürdoğan, Muhammet, Servet Altay, Selçuk Korkmaz, Çağlar Kaya, Utku Zeybey, Mustafa Ebik, and Melik Demir. 2019. "The Effect of Thyroid Stimulating Hormone Level Within the Reference Range on In-Hospital and Short-Term Prognosis in Acute Coronary Syndrome Patients" Medicina 55, no. 5: 175. https://doi.org/10.3390/medicina55050175