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Open Journal of Cardiology

ISSN: 2075-9010
Volume 5, 2014



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Open Journal of Cardiology, 2011, 2-3 [Research Article]

Impact of Thyroid Stimulating Hormone Level on Outcomes in Hypothyroid Patients With Acute Coronary Syndrome

Venkata M. Alla1, Wilbert S. Aronow3, Manu Kaushik1, Yeruva M. Reddy1, Swapna Kanuri2, Chandra K. Nair1
1 Division of Cardiology, Creighton University Medical Center, Omaha, NE
2 Department of Internal Medicine, Creighton University Medical Center, Omaha, NE
3 Cardiology Division, New York Medical College, Valhalla, NY

Corresponding Author & Address:

Wilbert S. Aronow
Cardiology Division, New York Medical College, Macy Pavilion, Room 138, Valhalla, NY 10595 USA
(Tel): 914-493-5311; (Fax): 914-235-6274; Email: wsaronow@aol.com

Article History:
Published: 25th May, 2011   Accepted: 25th May, 2011
Received: 20th April, 2011   Revised:  18th May, 2011

Open Journal of Cardiology, 2011, 2-3

©Aronow et al.; licensee Ross Science Publishers
ROSS Open Access articles will be distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided that the original work will always be cited properly.

Keywords: acute coronary syndrome, thyroid stimulating hormone, hypothyroidism

Abstract:

As the estimated prevalence of clinical or subclinical hypothyroidism (HT) in the United States is 5-17%, a significant number of acute coronary syndrome (ACS) patients are likely to have associated HT. We hypothesized that uncontrolled HT as evidenced by elevated thyroid stimulating hormone (TSH) would adversely influence outcomes in ACS. In this retrospective study, we selected patients with ACS and associated HT admitted to our institution between 2003 and 2007. Patients were divided into two groups: normal TSH (0.05 -6mU/L) and elevated TSH (> 6mU/L). One hundred and forty-eight (8.5%) out of 1746 patients with ACS had concomitant HT. TSH data were available in 138 patients. TSH was elevated in 30 (22%) and normal in 108 (78%) patients. Baseline characteristics were similar except for higher serum total cholesterol in the high TSH group. Overall, 20 patients (15%) had a major complication, and 7 (5%) died. There was no significant difference in revascularization rates, major complications, death or duration of hospitalization between both groups. Use of β blockers was lower in the high TSH group. None of the patients who were initiated on or had an escalation in their dose of levothyroxine (median dose: 25 mcg) had recurrent ischemia or sustained arrhythmias. Our study suggests that TSH level does not influence the presenting features and in-hospital outcomes in HT patients with ACS. Initiation or dose escalation of thyroid hormone in doses of ≤ 25 mcg in ACS patients appears safe in the short term.



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