Thyroid Hormone and Coronary Artery Disease: From Clinical Correlations to Prognostic Implications
Thyroid Hormone and Coronary Artery Disease: From Clinical Correlations to Prognostic Implications
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DOI：
10.1002/clc.20574
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发表时间：
2009-07-01
影响因子：
2.7
通讯作者：
L'Abbate, Antonio
中科院分区：
文献类型：
--
作者：
Coceani, Michele;Iervasi, Giorgio;L'Abbate, Antonio
背景：明显的甲状腺功能障碍，特别是甲状腺功能减退症，可能会导致冠状动脉疾病（CAD）。甲状腺激素代谢的更微妙的异常是否会影响CAD的进展仍然是一个推测的问题。假设：在没有原发性甲状腺疾病、心肌梗死或慢性心力衰竭病史的患者中，CAD的发生和长期预后与生物活性游离三碘甲状腺原氨酸（fT 3）的血清水平有关。该队列包括1047名临床和生化正常的甲状腺患者（中位年龄65.6岁，69%为男性）在我们研究所因疑似CAD接受冠状动脉造影。较低的fT 3水平可预测单支血管（p = 0.012）和多支血管（p = 0.009）CAD。通过多变量逻辑回归分析，fT 3仍然与CAD的存在相关（风险比[HR]：0.48，95%置信区间[CI]：0.34-0.68，p < 0.001）。平均随访31个月后，生存率为95%，总死亡率（log-rank 6.75，P = 0.009）和心源性死亡率（log-rank 8.26，P = 0.004）在低T3（fT 3）患者中较高
Background: Overt thyroid dysfunction, hypothyroidism in particular, may lead to coronary artery disease (CAD). Whether more subtle anomalies of thyroid hormone metabolism influence the progression of CAD remains a matter of speculation.Hypothesis; The occurrence of CAD and long-term prognosis in patients without a history of either primary thyroid disease, myocardial infarction, or chronic heart failure is related to serum levels of biologically active free triiodothyronine (fT3).Methods: The cohort consisted Of 1047 clinically and biochemically euthyroid patients (median age 65.6 y and 69% mate) who underwent coronary angiography in our institute for suspected CAD.Results: Lower fT3 levels were predictive of both single-vessel (p = 0.012) and multivessel (p = 0.009) CAD. Through a multivariate logistic regression analysis, fT3 was still linked to the presence of CAD (hazard ratio [HR]: 0.48, 95% confidence interval [CI]: 0.34-0.68, p < 0.001). After a mean follow-up Of 31 months, the survival rate was 95% and total mortality (log-rank 6.75, P = 0.009), as well as cardiac mortality (log-rank 8.26, p = 0.004), was greater among patients with low T3 (fT3