Impaired thyroid hormone sensitivity ups MACE, death risks in coronary angiography patients

Euthyroid patients undergoing coronary angiography who have impaired sensitivity to thyroid hormone are at increased risks of major adverse cardiovascular events (MACE) and cardiovascular death, a recent study has shown.

A total of 1,470 euthyroid participants who underwent coronary angiography between March and November 2013 were included in this prospective cohort study. The investigators followed the participants from July to November 2022.

Sensitivity to thyroid hormone was assessed by calculating the thyrotroph thyroxine resistance index (TT2RI), TSH index (TSHI), and feedback quantile-based index (TFQI). Finally, the association between thyroid hormone sensitivity and risk of MACE and cardiovascular death was analysed using Kaplan‒Meier curve and multivariable Cox proportional hazard model.

Of the participants, 1,089 completed the follow-up. Over a median follow-up duration of 111 months, the investigators identified 342 MACE cases and recorded 77 cardiovascular deaths.

Multivariate analysis revealed that greater levels of TFQI (hazard ratio [HR], 1.41, 95 percent confidence interval [CI], 1.08‒1.84; p=0.01 for trend), TT4RI (HR, 1.40, 95 percent CI, 1.06‒1.84; p=0.02 for trend), and TSHI (HR, 1.61, 95 percent CI, 1.22‒2.13; p=0.001 for trend) significantly correlated with a higher risk of MACE.

In addition, the increased levels of TFQI (HR, 2.21, 95 percent CI, 1.17‒4.17; p=0.02 for trend) and TSHI (HR, 2.05, 95 percent CI, 1.08‒3.91; p=0.03 for trend) also showed a significant association with a higher risk of cardiovascular death.

“Impaired sensitivity to thyroid hormone is associated with higher risks of MACE and cardiovascular death in a euthyroid population undergoing coronary angiography,” the investigators said.