Thyroid dysfunction and mortality in cardiovascular hospitalized patients.

Autor:	Frankel M; Endocrinology Unit, Shaare Zedek Medical Center.; Hebrew University Medical School, Jerusalem, Israel., Bayya F; Jesselson Integrated Heart Center, Shaare Zedek Medical Center.; Hebrew University Medical School, Jerusalem, Israel., Munter G; Endocrinology Unit, Shaare Zedek Medical Center.; Hebrew University Medical School, Jerusalem, Israel., Wolak A; Jesselson Integrated Heart Center, Shaare Zedek Medical Center.; Hebrew University Medical School, Jerusalem, Israel., Tolkin L; Endocrinology Unit, Shaare Zedek Medical Center.; Hebrew University Medical School, Jerusalem, Israel., Barenhoz-Goultschin O; Endocrinology Unit, Shaare Zedek Medical Center.; Hebrew University Medical School, Jerusalem, Israel., Asher E; Jesselson Integrated Heart Center, Shaare Zedek Medical Center.; Hebrew University Medical School, Jerusalem, Israel., Glikson M; Jesselson Integrated Heart Center, Shaare Zedek Medical Center.; Hebrew University Medical School, Jerusalem, Israel.
Jazyk:	angličtina
Zdroj:	Cardiovascular endocrinology & metabolism [Cardiovasc Endocrinol Metab] 2024 Jan 05; Vol. 13 (1), pp. e0299. Date of Electronic Publication: 2024 Jan 05 (Print Publication: 2024).
DOI:	10.1097/XCE.0000000000000299
Abstrakt:	Background: Thyroid dysfunction (TD) is associated with increased cardiovascular morbidity and mortality. Early detection may influence the clinical management. Objective: To determine the prevalence, predictors, and prognostic value of TD among hospitalized cardiac patients. Methods: A retrospective analysis of a 12-year database consisting of nonselectively adult patients admitted to a Cardiology Department and who were all screened for serum thyroid-stimulation-hormone (TSH) levels . Statistical analysis of demographic and clinical characteristics, mortality and length of hospital stay (LOS) was performed. Results: A total of 14369 patients were included in the study; mean age was 67 years, 38.3% females. 1465 patients (10.2%) had TD. The most frequent type of TD was mildly elevated TSH (5.4%) followed by mildly reduced TSH (2.1%), markedly elevated TSH (1.5%), and markedly reduced TSH (1.2%). Female gender, history of hypothyroidism, heart failure, atrial fibrillation, renal failure and amiodarone use were significantly associated with TD. During follow-up 2975 (20.7%) patients died. There was increased mortality in the mildly reduced TSH subgroup (hazard ratio [HR] =1.44), markedly elevated TSH subgroup (HR=1.40) and mildly elevated TSH subgroup (HR=1.27). LOS was longer for patients with TD; the longest stay was observed in the markedly elevated TSH subgroup (odds ratio=1.69). Conclusion: The prevalence of TD in hospitalized cardiac patients is 10.2%. TD is associated with an increased mortality rate and LOS. Consequently, routine screening for thyroid function in this population is advisable, particularly for selected high-risk subgroups. Future studies are needed to determine whether optimizing thyroid function can improve survival in these patients. Competing Interests: There are no conflicts of interest. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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