ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P780

Severity of coronary atherosclerosis in patients with different TSH levels

Anna Volkova, Elena Grineva & Svetlana Dora

St-Petersburg Medical University named I.P.Pavlov, St-Petersburg, Russian Federation.

Subclinical hypothyroidism (SH) is very frequent condition in older population. If can occur in 12–20% of patients older than 60. It is well known today that thyroid hormones can increase gene expression of APO-B receptors in the liver and by this way improve catabolism of atherogenic lipoproteins. They also can regulate processes of contractility and weakening of heart muscle. Decrease of cardiac output and diastolic disfunction of left ventricle can be revealed in SH patients. So even mild thyroid failure can promote the development and progression at heart ischemic disease. Results of coronarography (CG) can reliable reflect the severity of coronary atherosclerosis. It seems to us very important to compare results at CG with TSH level of heart ischemic disease patients.

Methods: Four hundred and eighty-nine patients participated in our study. In all patients, CG was performed by standart methodology of Judkins et al. We studied age, gender, body mass index of patients, their smoking history, genetic predisposition. Fasting blood samples were taken for measuring of TSH level by reagent of third generation.

Results: There were 77.4% of men and of men and 22.6% of women. Middle age was 56.53±0.41 years. BMI was 27.23±0.17 kg/m2; TSH level was 2.53±0.30 IU/l. In 9.5% of patients, SH was revealed (TSH level was more than 4.0 IU/l), in 5.8% of cases TSH level was <0.5 IU/l, which characterize. SH was revealed in 15.8% of women and 6.7% of men. There was positive correlation between TSH level and BMI in all patients (P=0.008; r=0.127) and TSH level and age in women (P=0.043; r=0.143). Multivessel damage of coronary vessels correlated with man gender, age, duration of smoking, genetic predisposition, hypertension and diabetes mellitus and TSH level more than IU/l (P=0.041, r=0.172). The trunkal damage of left coronary artery was also associated with elevation of TSH level. In patients with SH trunkal damage was revealed in 38% of cases, when in patients with normal TSH level only in 19.3%.

Conclusion: In heart ischemic disease patients, SH was associated with women gerder, elevation of BMI and severity of coronary atherosclerosis.

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