title: Prognostic value of thyroid-stimulating hormone within reference range in patients with coronary artery disease.
abstract: BACKGROUND
  Thyroid-stimulating hormone (TSH) in the upper part of reference range is associated with cardio-metabolic disorders. The association of TSH within reference range with prognosis of patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI) remains poorly investigated.
  
  
  METHODS
  The study included 8010 consecutive patients with CAD who were treated with PCI. All patients had a TSH level within reference range (0.3 to 4.0 mU/L). The primary outcome was 3-year all-cause mortality.
  
  
  RESULTS
  TSH tertiles were: 1st tertile (0.3 mU/L to <1.02 mU/L; n=2694), 2nd tertile (1.02 mU/L to <1.67 mU/L; n=2654) and 3rd tertile (1.67 mU/L to 4.00 mU/L; n=2662). The primary outcome (3-year mortality) occurred in 753 patients: 240 deaths in the 1st, 227 deaths in the 2nd and 286 deaths in the 3rd TSH tertile (Kaplan-Meier estimates of mortality 10.2%, 9.8% and 12.3%; adjusted hazard ratio [HR]=1.31, 95% confidence interval [CI] 1.04-1.66 for each tertile increase). TSH level was associated with 30-day mortality (mortality estimates, 1.6% in the 1st, 1.6% in the 2nd and 3.5% in the 3rd TSH tertile; adjusted HR=2.30 [1.33-3.97] for each tertile increase) but not with 30-day to 3-year mortality (mortality estimates, 8.6% in the 1st, 8.2% in the 2nd and 8.8% in the 3rd TSH tertile; P=0.603). The incidence of cardiogenic shock or peri-PCI bleeding was increased in patients in the upper TSH tertile.
  
  
  CONCLUSIONS
  In patients with CAD undergoing PCI, TSH level in the upper part of reference range was associated with increased risk of mortality after PCI.
authors: Deutsches Herzzentrum München, Technische Universität, Munich, Germany. Electronic address: ndrepepa@dhm.mhn.de.
authors: Gjin
authors: G
authors: Ndrepepa
authors: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors: Siegmund
authors: S
authors: Braun
authors: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors: Katharina
authors: K
authors: Mayer
authors: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors: Salvatore
authors: S
authors: Cassese
authors: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors: Massimiliano
authors: M
authors: Fusaro
authors: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors: Robert A
authors: RA
authors: Byrne
authors: 1. Medizinische Klinik rechts der Isar, Technische Universität, Munich, Germany.
authors: Petra
authors: P
authors: Hoppmann
authors: Deutsches Herzzentrum München, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors: Heribert
authors: H
authors: Schunkert
authors: 1. Medizinische Klinik rechts der Isar, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors: Karl-Ludwig
authors: KL
authors: Laugwitz
authors: Deutsches Herzzentrum München, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors: Adnan
authors: A
authors: Kastrati
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D012016:Reference Values; D016019:Survival Analysis; D013960:Thyroid Function Tests / Q000592:standards; D013972:Thyrotropin / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D013972:Thyrotropin
keywords: Coronary artery disease; Mortality; Thyroid-stimulating hormone