Hypothyroidism and acute coronary syndrome

Abstract

Introduction: Hypothyroidism is a disease that affects approximately 5 to 15% of the population. Its presence could behave as a cardiovascular risk factor, due to its effects on lipid metabolism, increased pro-inflammatory and pro-coagulant activity. Objectives: To assess the prevalence of hypothyroidism in patients hospitalized for acute coronary syndrome (ACS) and its prognostic implication. Material and methods: Retrospective and observational study that included patients admitted to the Coronary Unit of the Institute of Cardiology of Corrientes by ACS from 01/01/13 to 05/23/15. The population was divided into two groups: 1 (with hypothyroidism) and 2 (without hypothyroidism). Categorical variables were expressed as percentages and were analyzed using
the Chi-square test and continuous variables were expressed as mean ± standard deviation and analyzed by Student's T Test. Statistical analysis was performed using the SPSS 21.0.0 program. Statistically significant differences were considered, p values <0.005. Results: There were 607 patients included, of which 6% belonged to group 1. Hypothyroid patients had a higher rate of male sex (79% vs. 51%, p=0.02), diabetes (46% vs. 30%, p=0.01) and dyslipidemia (66% vs. 52%, p=0.01). There were more smokers between non-hypothyroid patients (30% vs. 6%). During hospitalization, there were no statistically significant differences regarding the risk of death (5.7% vs. 4.5%) and complications associated with ACS (11% re-infarction vs 5%; cardiogenic shock 6% vs 5% and atrial fibrillation 6% vs 10 %). However, the 30-day follow-up showed a higher death rate (21.2% vs 9%; p 0.002) and stroke (5.7% vs 0.7%; p 0.004) in group 1. Conclusions: Hypothyroidism is a rare entity in patients hospitalized for acute coronary syndrome. Its presence was associated with a higher rate of re-infarction during hospitalization, and higher mortality in the 30-day follow-up.