Outcome of percutaneous transluminal coronary angioplasty in patients with subclinical hypothyroidism.
To determine the outcomes of percutaneous transluminal angioplasty (PTCA) in patients with subclinical hypothyroidism and to compare them with those in euthyroid patients, we studied retrospectively 48 hypothyroid (4 overtly and 44 subclinically hypothyroid) and 122 euthyroid patients who had a PTCA in Boston's Beth Israel Hospital between 1984 and 1994. No significant differences were detected in bradycardia (relative risk, RR: 0.96), tachyarrhythmia (RR: 0.62), heart failure (RR: 2.27), hypotension (RR: 1.95), or bleeding (RR: 2.48) in the immediate postprocedure period between euthyroid and subclinically hypothyroid patients. There was a trend towards an increased incidence of chest pain (43.2 vs 27.5%, RR: 1.57, p = 0.084), dissection (50 vs 33%, RR: 1.51, p = 0.06) as an immediate, and reocclusion as an early (within 2 weeks) postprocedure complication (6.25 vs .9%, RR: 6.81, p = 0.08). However, chest pain accompanied by electrocardiographic changes was not significantly different between the two groups (20.5 vs 14.7%, RR: 1.4, p = 0.47). There was no difference in the number of procedures rated as successful (subclinically hypothyroid vs euthyroid: 90.2 vs 92.7%). Hospital charges, discharge destination, interval to next admission to the hospital, and in-hospital mortality were not different between the two groups. Subclinical hypothyroidism does not appear to be a risk factor for significant morbidity or increased mortality following PTCA. Prospective long-term studies with increased statistical power are needed to clarify whether there is an association between hypothyroidism and complications (especially chest pain, dissection, and/or reocclussion) in the early (2 weeks) and late (6 months) post-PTCA period.
Mantzoros
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Division of Endocrinology, Charles A. Dana Research Institute, Boston, Massachusetts 02215, USA.
Evagelopoulou
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Moses
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D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D002637:Chest Pain; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000097:blood
D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine