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Sang Yoon Kim 1 Article
Clinical Study
Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
Hana Kim, Sung Hye Kong, Jae Hoon Moon, Sang Yoon Kim, Kay-Hyun Park, Jun Sung Kim, Joong Haeng Choh, Young Joo Park, Cheong Lim
Endocrinol Metab. 2020;35(2):308-318.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.308
  • 6,849 View
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  • 9 Web of Science
  • 10 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The aim of this study was to determine the associations between subclinical hypothyroidism (SCH) and long-term cardiovascular outcomes after coronary artery bypass grafting (CABG) or heart valve surgery (HVS).
Methods
We retrospectively reviewed and compared all-cause mortality, cardiovascular mortality, and cardiovascular events in 461 patients who underwent CABG and 104 patients who underwent HVS.
Results
During a mean±standard deviation follow-up duration of 7.6±3.8 years, there were 187 all-cause deaths, 97 cardiovascular deaths, 127 major adverse cardiovascular events (MACE), 11 myocardial infarctions, one unstable angina, 70 strokes, 30 hospitalizations due to heart failure, 101 atrial fibrillation, and 33 coronary revascularizations. The incidence of all-cause mortality after CABG was significantly higher in patients with SCH (n=36, 55.4%) than in euthyroid patients (n=120, 30.3%), with a hazard ratio of 1.70 (95% confidence interval, 1.10 to 2.63; P=0.018) after adjustment for age, sex, current smoking status, body mass index, underlying diseases, left ventricular dysfunction, and emergency operation. Interestingly, low total triiodothyronine (T3) levels in euthyroid patients who underwent CABG were significantly associated with increased risks of all-cause mortality, cardiovascular mortality, and MACE, but those associations were not observed in HVS patients. Both free thyroxine and thyroid-stimulating hormone levels in euthyroid patients were not related with any cardiovascular outcomes in either the CABG or HVS group.
Conclusion
SCH or low total T3 might be associated with a poor prognosis after CABG, but not after HVS, implying that preoperative thyroid hormonal status may be important in ischemic heart disease patients.

Citations

Citations to this article as recorded by  
  • Subclinical hypothyroidism and clinical outcomes after cardiac surgery: A systematic review and meta-analysis
    Michele Dell’Aquila, Camilla S. Rossi, Tulio Caldonazo, Gianmarco Cancelli, Lamia Harik, Giovanni J. Soletti, Kevin R. An, Jordan Leith, Hristo Kirov, Mudathir Ibrahim, Michelle Demetres, Arnaldo Dimagli, Mohamed Rahouma, Mario Gaudino
    JTCVS Open.2024; 18: 64.     CrossRef
  • Impact of subclinical hypothyroidism on outcomes after coronary artery bypass grafting: a systematic review and meta-analysis
    Muhammad O. LARIK, Abdul R. SHAHID, Moeez I. SHIRAZ, Maryam UROOJ
    The Journal of Cardiovascular Surgery.2024;[Epub]     CrossRef
  • The Association Between Hypothyroidism Treatment and Mortality in Patients Hospitalized in Surgical Wards
    Hiba Masri-Iraqi, Yaron Rudman, Carmel Friedrich Dubinchik, Idit Dotan, Talia Diker-Cohen, Liat Sasson, Tzipora Shochat, Ilan Shimon, Eyal Robenshtok, Amit Akirov
    Endocrine Research.2023; 48(2-3): 68.     CrossRef
  • Mid-term outcomes of patients with subclinical hypothyroidism after coronary bypass surgery
    Dong Zhao, Wei Zhao, Chuangshi Wang, Fei Xu, Wei Zhao, Xieraili Tiemuerniyazi, Hao Ma, Wei Feng
    Interdisciplinary CardioVascular and Thoracic Surgery.2023;[Epub]     CrossRef
  • Thyroid Pathology in High-Risk Cardiac Surgery Patients with Coronary Artery Disease
    Olena K. Gogayeva, Anatoliy V. Rudenko, Vasyl V. Lazoryshynets, Serhii A. Rudenko, Tetiana A. Andrushchenko
    Ukrainian Journal of Cardiovascular Surgery.2022; 30(1 (46)): 9.     CrossRef
  • High-TSH Subclinical Hypothyroidism Is Associated With Postoperative Mortality in Acute Type A Aortic Dissection
    Shi-Pan Wang, Yuan Xue, Hai-Yang Li, Wen-Jian Jiang, Hong-Jia Zhang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Triiodothyronine improves contractile recovery of human atrial trabeculae after hypoxia/reoxygenation
    Petra Kleinbongard, Philipp Kuthan, Chantal Eickelmann, Philipp Jakobs, Joachim Altschmied, Judith Haendeler, Arjang Ruhparwar, Matthias Thielmann, Gerd Heusch
    International Journal of Cardiology.2022; 363: 159.     CrossRef
  • Hypothyroidism Is Correlated with Ventilator Complications and Longer Hospital Days after Coronary Artery Bypass Grafting Surgery in a Relatively Young Population: A Nationwide, Population-Based Study
    Jiun-Yu Lin, Pei-Chi Kao, Yi-Ting Tsai, Chi-Hsiang Chung, Wu-Chien Chien, Chih-Yuan Lin, Chieh-Hua Lu, Chien-Sung Tsai
    Journal of Clinical Medicine.2022; 11(13): 3881.     CrossRef
  • Minor perturbations of thyroid homeostasis and major cardiovascular endpoints—Physiological mechanisms and clinical evidence
    Patrick Müller, Melvin Khee-Shing Leow, Johannes W. Dietrich
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape
    Won Sang Yoo, Hyun Kyung Chung
    Endocrinology and Metabolism.2021; 36(3): 500.     CrossRef
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