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Open AccessArticle

Unknown Subclinical Hypothyroidism and In-Hospital Outcomes and Short- and Long-Term All-Cause Mortality among ST Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

1
Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
2
Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel
3
Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
*
Author to whom correspondence should be addressed.
Drs Izkhakov and Zahler contributed equally to the manuscript.
J. Clin. Med. 2020, 9(12), 3829; https://doi.org/10.3390/jcm9123829
Received: 17 October 2020 / Revised: 19 November 2020 / Accepted: 23 November 2020 / Published: 26 November 2020
(This article belongs to the Section Cardiology)
Subclinical hypothyroidism (SCH) is defined as an elevated serum thyroid-stimulating hormone (TSH) level with a normal serum-free thyroxine (FT4) level. SCH has been associated with an increased risk of adverse cardiovascular outcomes. We investigated possible associations of unknown SCH with in-hospital outcomes and short- and long-term all-cause mortality in a large cohort of patients with ST segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). This retrospective, single-center observational study evaluated the TSH and FT4 levels of 1593 STEMI patients with no known history of hypothyroidism or thyroid replacement treatment who were admitted to the coronary care unit and underwent PCI between 1/2008 and 8/2017. SCH was defined as TSH levels ≥ 5 mU/mL in the presence of normal FT4 levels. Unknown SCH was detected in 68/1593 (4.2%) STEMI patients. These patients had significantly worse in-hospital outcomes compared to patients without SCH, including higher rates of acute kidney injury (p = 0.003) and left ventricular ejection fraction ≤ 40% (p = 0.03). Moreover, 30-day mortality (p = 0.02) and long-term (mean 4.2 ± 2.3 years) mortality (p = 0.007) were also significantly higher in patients with SCH. The thyroid function of STEMI patients should be routinely tested before they undergo a planned PCI procedure. View Full-Text
Keywords: subclinical hypothyroidism; ST elevation; myocardial infarction; percutaneous coronary intervention; thyroid function evaluation subclinical hypothyroidism; ST elevation; myocardial infarction; percutaneous coronary intervention; thyroid function evaluation
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MDPI and ACS Style

Izkhakov, E.; Zahler, D.; Rozenfeld, K.-L.; Ravid, D.; Banai, S.; Topilsky, Y.; Stern, N.; Greenman, Y.; Shacham, Y. Unknown Subclinical Hypothyroidism and In-Hospital Outcomes and Short- and Long-Term All-Cause Mortality among ST Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention. J. Clin. Med. 2020, 9, 3829. https://doi.org/10.3390/jcm9123829

AMA Style

Izkhakov E, Zahler D, Rozenfeld K-L, Ravid D, Banai S, Topilsky Y, Stern N, Greenman Y, Shacham Y. Unknown Subclinical Hypothyroidism and In-Hospital Outcomes and Short- and Long-Term All-Cause Mortality among ST Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention. Journal of Clinical Medicine. 2020; 9(12):3829. https://doi.org/10.3390/jcm9123829

Chicago/Turabian Style

Izkhakov, Elena; Zahler, David; Rozenfeld, Keren-Lee; Ravid, Dor; Banai, Shmuel; Topilsky, Yan; Stern, Naftali; Greenman, Yona; Shacham, Yacov. 2020. "Unknown Subclinical Hypothyroidism and In-Hospital Outcomes and Short- and Long-Term All-Cause Mortality among ST Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention" J. Clin. Med. 9, no. 12: 3829. https://doi.org/10.3390/jcm9123829

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