Seo SM, et al. - In patients with acute myocardial infarction (AMI), researchers examined the connection between thyroid-stimulation hormone (TSH) elevation and long-term clinical outcomes. According to the findings obtained, AMI patients with TSH elevation had a worse clinical outcome. In patients with AMI, TSH elevation was a predictor of all-cause mortality.

Methods

• For this investigation, researchers consecutively enrolled 4748 AMI patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents.
• One thousand, nine hundred seventy-seven patients whose thyroid function data available after the exclusion of hyperthyroidism and possible central hypothyroidism were analyzed.
• After that, patients were divided into two groups;
  • Euthyroid group (n=1846) with normal TSH and normal free thyroxine (FT4);
  • hypothyroidism group (n=131) with elevated TSH and normal or low FT4.
• With their all-cause and cardiac mortalities, the two groups were subsequently compared.

Results

• According to the findings obtained, median follow-up duration was 3.5 years.
• Findings revealed that hypothyroidism group were older, included in more females, and had higher incidences of atrial fibrillation, stroke, and renal dysfunction.
• It was noted that elevated TSH was related to significantly higher all-cause mortality (26.0% vs 11.7%, P < 0.0001) and cardiac mortality (9.2% vs 4.6%, P=0.014).
• The multivariate Cox proportional hazards model identified that significant predictor of all-cause mortality (adjusted hazard ratio 1.560, 95% confidence interval 1.017 to 2.392, P = 0.041) was TSH elevation.