DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20171260

Study on prevalence of hypothyroidism in ST segment elevation myocardial infarction

Sreevidya K. R., Renymol B.

Abstract


Background: Both subclinical and overt hypothyroidism have effects on myocardial contractility and cardiovascular haemodynamics. In addition, changes in lipids, low levels of inflammation, elevated homocysteine etc. contribute to accelerated atherosclerosis and increased cardio vascular mortality and morbidity in hypothyroidism. In this study, we tried to find out the prevalence of hypothyroidism in patients admitted with acute ST elevation myocardial infarction. We also tried to assess the BMI, diastolic BP and lipid profile of these patients.

Methods: A cross sectional study was done among patients admitted with ST elevation myocardial infarction in Coimbatore Medical College, Coimbatore, Tamil Nadu, India. We collected information on BMI, blood pressure, lipid profile and thyroid function of these patients.

Results: The prevalence of hypothyroidism was found to be 14% in patients admitted with ST elevation MI. Hypothyroidism was three times more common in women. Patients with hypothyroidism was found to have higher BMI, elevated total cholesterol, triglycerides and LDL which was statistically significant. Higher prevalence of diastolic hypertension was also seen among hypothyroid patients.

Conclusions: Thyroid hormone has various actions on heart. Hypothyroidism has increased cardiovascular morbidity and mortality. The associated risk factors like obesity, hyperlipidaemia and diastolic hypertension contribute to this. Patients with coronary artery disease should be screened for hypothyroidism.

 


Keywords


Hypothyroidism, ST elevation myocardial infarction

Full Text:

PDF

References


Hutson MR, Kirby ML. Model systems for the study of heart development and disease: cardiac neural crest and construal malformations. In: Seminars in cell and developmental biology. Academic Press. 2007;18(1):101-10.

Olivieri A, Stazi MA, Mastroiacovo P, Fazzini C, Medda E, Spagnolo A, et al. A population-based study on the frequency of additional congenital malformations in infants with congenital hypothyroidism: data from the Italian Registry for Congenital Hypothyroidism (1991–1998). J Clin Endocrinol Metab. 2002;87(2):557-62.

Monzani F, Di Bello V, Caraccio N, Bertini A, Giorgi D, Giusti C, Ferrannini E. Effect of levothyroxine on cardiac function and structure in subclinical hypothyroidism: a double blind, placebo-controlled study. J Clin Endocrinol Metab. 2001;86(3):1110-5.

Carr AN, Kranias EG. Thyroid hormone regulation of calcium cycling proteins. Thyroid. 2002;12(6):453-74

Dillmann WH. Cellular action of thyroid hormone on the heart. Thyroid. 2002;12(6):447-52.

Klein I. Thyroid hormone and the cardiovascular system. Am J Med. 1990;88(6):631.

Gumieniak O, Perlstein TS, Hopkins PN, Brown NJ, Murphey LJ, Jeunemaitre X, et al. Thyroid function and blood pressure homeostasis in euthyroid subjects. J Clin Endocrinol Metab. 2004;89(7):3455-61.

Walsh JP, Bremner AP, Bulsara MK, O'Leary P, Leedman PJ, Feddema P, et al. Thyroid dysfunction and serum lipids: a community‐ based study. Clin Endocrinol. 2005;63(6):670-5.

Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160(4):526-34.

Duntas LH, Brenta G. The effect of thyroid disorders on lipid levels and metabolism. Med Clin North Am. 2012;96(2):269-81.

Tian L, Song Y, Xing M, Zhang W, Ning G, Li X, et al. A novel role for thyroid‐stimulating hormone: Up‐regulation of hepatic 3‐hydroxy‐3‐methyl‐glutaryl‐coenzyme a reductase expression through the cyclic adenosine monophosphate/protein kinase A/cyclic adenosine monophosphate–responsive element binding protein pathway. Hepatology. 2010;52(4):1401-9.

Mayer Jr O, Šimon J, Filipovský J, Plášková M, Pikner R. Hypothyroidism in coronary heart disease and its relation to selected risk factors. Vascular Health and Risk Management. 2006;2(4):499.

Auer J, Berent R, Weber T, Lassnig E, Eber B. Thyroid function is associated with presence and severity of coronary atherosclerosis. Clin Cardiol. 2003;26(12):569-73.

Biondi B, Palmieri EA, Lombardi G, Fazio S. Effects of subclinical thyroid dysfunction on the heart. Ann Intern Med. 2002;137(11):904-14.

Walsh JP, Bremner AP, Bulsara MK, O’Leary P, Leedman PJ, Feddema P, et al. Subclinical thyroid dysfunction as a risk factor for cardiovascular disease. Arch Intern Med. 2005;165(21):2467-72.

Tuzcu A, Bahceci M, Gokalp D, Tuzun Y, Gunes K. Subclinical hypothyroidism may be associated with elevated high-sensitive c-reactive protein (low grade inflammation) and fasting hyperinsulinemia. Endocrine J. 2005;52(1):89-94.

Kvetny J, Heldgaard PE, Bladbjerg EM, Gram J. Subclinical hypothyroidism is associated with a low‐grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin Endocrinol. 2004;61(2):232-8.

Knudsen N, Laurberg P, Rasmussen LB, Bülow I, Perrild H, Ovesen L, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005;90(7):4019-24.

Åsvold BO, Vatten LJ, Nilsen TI, Bjøro T. The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study. Eur J Endocrinol. 2007;156(2):181-6.

Iervasi G, Molinaro S, Landi P, Taddei MC, Galli E, Mariani F, et al. Association between increased mortality and mild thyroid dysfunction in cardiac patients. Arch Intern Med. 2007;167(14):1526-32.

Rodondi N, Aujesky D, Vittinghoff E, Cornuz J, Bauer DC. Subclinical hypothyroidism and the risk of coronary heart disease: a meta-analysis. Am J Med. 2006;119(7):541-51.

Imaizumi M, Akahoshi M, Ichimaru S, Nakashima E, Hida A, Soda M, et al. Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism. J Clin Endocrinol Metab. 2004;89(7):3365-70.

Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med. 2000;132(4):270-8.