Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Data Collection
2.3. Measurement of Thyroid Hormone and Definition of Hyperthyroidism
2.4. Invasive CAG and EG Provocation Test
2.5. Statistical Analyses
3. Results
3.1. Baseline Characteristics
3.2. Effect of Hyperthyroidism on VA
3.3. Clinical Outcomes in Patients with VA
4. Discussion
4.1. Sex Differences in the Effects of Hyperthyroidism on Vasospasm
4.2. Clinical Significance and Implications
4.3. Study Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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All (n = 1239) | VA (n = 831) | Non-VA (n = 408) | |
---|---|---|---|
Age, years | 55.4 ± 11.7 | 55.3 ± 11.4 | 55.4 ± 12.4 |
Male, n (%) | 629 (50.8) | 485 (58.4) | 144 (35.3) |
BMI, kg/m2 † | 24.4 (22.5–26.7) | 24.4 (22.5–26.6) | 24.5 (22.6–26.8) |
Previous CAD, n (%) | 133 (10.7) | 97 (11.7) | 36 (8.8) |
Diabetes mellitus, n (%) | 115 (9.3) | 69 (8.3) | 46 (11.3) |
Hypertension, n (%) | 463 (37.4) | 317 (38.1) | 146 (35.8) |
Dyslipidemia, n (%) | 168 (13.6) | 105 (12.7) | 63 (15.4) |
Alcohol drinking, n (%) | 449 (36.2) | 326 (39.2) | 123 (30.1) |
Current smoking, n (%) | 272 (22.0) | 224 (27.1) | 48 (11.8) |
Laboratory finding | |||
TSH, μIU/mL † | 1.6 (1.0–2.4) | 1.5 (1.0–2.3) | 1.7 (1.1–2.6) |
Free T4, ng/dL † | 1.2 (1.0–1.3) | 1.2 (1.1–1.4) | 1.2 (1.0–1.3) |
T3, ng/dL †,‡ | 2.1 (1.4–99.7) | 2.0 (1.4–99.4) | 2.3 (1.5–100.4) |
Hyperthyroidism, n (%) | 98 (7.9) | 83 (10.0) | 15 (3.7) |
Hypothyroidism, n (%) | 59 (4.8) | 42 (5.1) | 17 (4.2) |
LVEF, % † | 64.0 (61.2–67.9) | 64.0 (61.0–68.0) | 64.2 (61.5–67.7) |
Previous cardiovascular medication | |||
Antiplatelet, n (%) | 225 (18.2) | 163 (19.6) | 62 (15.2) |
Stains, n (%) | 166 (13.4) | 105 (12.6) | 61 (15.0) |
CCBs, n (%) | 219 (17.7) | 153 (18.4) | 66 (16.2) |
Clinical diagnosis before ergonovine provocation test | |||
Angina, n (%) | 1087 (87.7) | 722 (86.9) | 365 (89.5) |
Myocardial infarction, n (%) | 22 (1.8) | 18 (2.2) | 4 (1.0) |
Cardiac arrest, n (%) | 8 (0.6) | 6 (0.7) | 2 (0.5) |
Syncope, n (%) | 18 (1.5) | 10 (1.2) | 8 (2.0) |
VT or VF, n (%) | 6 (0.5) | 4 (0.5) | 2 (0.5) |
AV block, n (%) | 1 (0.1) | 1 (0.1) | 0 (0.0) |
Univariate | Multivariable | |||||
---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | |
Hyperthyroidism * | 2.91 | 1.655–5.106 | <0.001 | 3.27 | 1.811–5.897 | <0.001 |
TSH, μIU/mL | 0.98 | 0.946–1.008 | 0.137 | - | - | - |
Free T4, ng/dL | 1.22 | 1.092–1.362 | <0.001 | - | - | - |
T3, ng/dL | 1.00 | 0.997–1.003 | 0.953 | - | - | - |
Sex, male | 2.57 | 2.011–3.285 | <0.001 | 2.19 | 1.644–2.907 | <0.001 |
Age | 1.00 | 0.989–1.009 | 0.892 | - | - | - |
Previous CAD | 1.37 | 0.913–2.042 | 0.129 | - | - | - |
Hypertension | 1.11 | 0.865–1.416 | 0.419 | - | - | - |
Diabetes | 0.71 | 0.481–1.056 | 0.091 | - | - | - |
Dyslipidemia | 0.80 | 0.567–1.115 | 0.184 | - | - | - |
Current smoking | 2.78 | 1.981–3.896 | <0.001 | 1.92 | 1.311–2.804 | 0.001 |
Alcohol drinking | 1.50 | 1.161–1.927 | 0.002 | 0.91 | 0.675–1.218 | 0.515 |
VA Group | ||||
---|---|---|---|---|
All (n = 831) | Presence of Hyperthyroidism (n = 83) | Absence of Hyperthyroidism (n = 748) | p Value | |
Composite events | 30 (3.6) | 2 (2.4) | 28 (3.7) | 0.760 |
Cardiac death | 2 (0.2) | 0 (0.0) | 2 (0.3) | >0.999 |
ACS | 24 (2.9) | 2 (2.4) | 22 (2.9) | >0.999 |
VT or VF | 2 (0.2) | 0 (0.0) | 2 (0.3) | >0.999 |
AV block | 3 (0.4) | 0 (0.0) | 3 (0.4) | >0.999 |
All-cause death | 4 (0.5) | 0 (0.0) | 4 (0.5) | >0.999 |
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Kim, H.-J.; Jo, S.-H.; Lee, M.-H.; Seo, W.-W.; Baek, S.H. Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes. J. Clin. Med. 2020, 9, 3020. https://doi.org/10.3390/jcm9093020
Kim H-J, Jo S-H, Lee M-H, Seo W-W, Baek SH. Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes. Journal of Clinical Medicine. 2020; 9(9):3020. https://doi.org/10.3390/jcm9093020
Chicago/Turabian StyleKim, Hyun-Jin, Sang-Ho Jo, Min-Ho Lee, Won-Woo Seo, and Sang Hong Baek. 2020. "Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes" Journal of Clinical Medicine 9, no. 9: 3020. https://doi.org/10.3390/jcm9093020
APA StyleKim, H.-J., Jo, S.-H., Lee, M.-H., Seo, W.-W., & Baek, S. H. (2020). Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes. Journal of Clinical Medicine, 9(9), 3020. https://doi.org/10.3390/jcm9093020