Study of the Risk Factors for Coronary Artery Disease and their Correlation with Thyroid Hormone Profile amongst Women with ST Segment Elevation in Acute Myocardial Infarction

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Authors

  • Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003 ,IN
  • Former PG Resident, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003 ,IN
  • Associate Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003 ,IN

Keywords:

MI-Myocardial Infarction, Hyperthyroidism, Hypothyroidism, STEMI-ST- Segment Elevation Myocardial Infarction, TSH- Thyroid Stimulating Hormone

Abstract

Background: Thyroid hormone has a major role in the cardiovascular function and cardiac hemodynamics as well as to maintain the cardiovascular homeostasis. The present study was planned to assess risk factors for coronary artery disease and their correlation with thyroid hormone profile amongst women with ST segment elevation in acute myocardial infraction. Material and Methods: A total number of 78 females having ST elevation myocardial infarction diagnosed through detailed clinical history and ECG evaluations were included after they satisfy the eligibility criteria. Patients were subsequently evaluated for presence of risk factors of ischemic heart disease such age, marital status, parity, and menopause, use of oral contraceptives, family history, obesity, diabetes mellitus, hypertension, hypercholesterolemia and hypertriglyceridemia. Their thyroid hormone profiles (T3, T4, TSH) were done and were correlated with risk factors for ischemic heart disease. Results: A total 78 patient included in the study most of the study population belongs to the age group of 40 to 50 years (43.6 %). Hypertension was the most common clinical features amongst study population (59%) followed by Diabetes (50%). Most of the study population had Normal Thyroid status (57.69%) followed by Hypothyroidism (25.64%) and Hyperthyroidism (16.67%) and SERUM TSH is the most sensitive test for evaluation. Diabetes Mellitus was statistically significant risk factor (p valueConclusion: Patients with coronary artery disease especially in the presence of other risk factors should be screened for thyroid dysfunction specially diabetes. We recommend tests for thyroid disorders in acute coronary syndrome can give predictor for risk of morbidity and mortality in those subjects.

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2021-01-01

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References

Heart Disease and Stroke Statistics-2009 Update: A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.

Kim ESH, Carrigan TP, Menon V; Enrollmentof women in National Heart, Lung, and Blood Institute-funded cardiovascular randomized controlled trials fails to meet current federal mandates for inclusion. J Am Coll Cardiol. 2008; 52(8):672-3. https://doi.org/10.1016/j. jacc.2008.05.025 PMid:18702973

Pepine CJ. Ischemic heart disease in women. J Am Coll Cardiol. 2006; 47:S1-S3. https://doi.org/10.1016/j. jacc.2005.10.022 PMid:16458166

Mikhail GW. Coronary heart disease in women. BMJ. 2005; 331(7515):467-8. https://doi.org/10.1136/bmj.331.7515.467 PMid:16141136 PMCid:PMC1199011

Wenger NK. Coronary heart disease: The female heart is vulnerable. Prog Cardiovasc Dis. 2003; 46(3):199-299. https://doi.org/10.1016/j.pcad.2003.08.003 PMid:14685940

Stampfer MJ, Colditz GA, Willett WC, Manson JE, Rosner B, Speizer FE. Postmenopausal estrogen therapy and cardiovascular disease. Ten-year follow-up from the nurses health study. N Engal J Med. 1991; 325:756-762. https://doi. org/10.1056/NEJM199109123251102 PMid:1870648

Stamfer MJ, Colditz GA; Estrogen replacement therapy and coronary heart disease: Quantitative assessment of the epidemiologic evidence. Prev Med. 1991; 20(1):47-63. https://doi.org/10.1016/0091-7435(91)90006-P

Enas EA, Senthilkumar A, Juturu V, Gupta R. Coronary artery disease in women. Indian Heart J. 2001; 53:282-92.

O’Toolee ML. Exercise and physical activity. In Douglas PS editor. Cardiovascular health and disease in women. Philadelphia: W. B. Saunders; 1993.p. 253-68.

Manson JE, Colditz GA, Stamfer MJ, Willet WC, Rosner B, Manson RR. A prospective study of obesity and risk of coronary heart disease in women. N Engl JMed. 1990; 322(13):882-889. https://doi.org/10.1056/ NEJM199003293221303 PMid:2314422

Danzi S, Klein I. Thyroid disease and the cardiovascular system. Endocrinol Metab Clin North Am. 2014; 43(2):517- 28. doi: 10.1016/j.ecl.2014.02.005. https://doi.org/10.1016/j. ecl.2014.02.005 PMid:24891175

Fazio S, Palmieri EA, Lombardi G, Biondi B. Effects of thyroid hormone on the cardiovascular system. Recent Prog Horm Res. 2004; 59:31-50. https://doi.org/10.1210/ rp.59.1.31 PMid:14749496

Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007; 116(15):1725-35. https://doi.org/10.1161/ CIRCULATIONAHA.106.678326 PMid:17923583

Danzi S, Klein I. Alterations in thyroid hormones that accompany cardiovascular disease. Clinical Thyroidology. 2009; 21(1):3-5.

Boekholdt SM, Titan SM, Wiersinga WM, Chatterjee K, Basart DC, Luben R, et al. Initial thyroid status and cardiovascular risk factors: The EPIC-Norfolk prospective population study. Clin Endocrinol (Oxf). 2010; 72(3):404- 10. https://doi.org/10.1111/j.1365-2265.2009.03640.x PMid:19486022

Ertek S, Cicero AF. Hyperthyroidism and cardiovascular complications: A narrative review on the basis of pathophysiology. Arch Med Sci. 2013; 9(5):944-52. https://doi.org/10.5114/aoms.2013.38685 PMid:24273583 PMCid:PMC3832836

Pimentel RC, Cardoso GP, Escosteguy CC, Abreu LM. Thyroid hormone profile in acute coronary syndromes. Arq Bras Cardiol. 2006; 87(6):688-94. https://doi.org/10.1590/ S0066-782X2006001900002

Coceani M. Heart disease in patients with thyroid dysfunction: hyperthyroidism, hypothyroidism and beyond. Anadolu Kardiyol Derg. 2013; 13(1):62-6. https:// doi.org/10.5152/akd.2013.008 PMid:23086805

Grais IM, Sowers JR. Thyroid and the heart. Am J Med. 2014; 127(8):691-8. https://doi.org/10.1016/j. amjmed.2014.03.009 PMid:24662620 PMCid:PMC4318631

Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine. 2004; 24(1):1-13. https://doi.org/10.1385/ENDO:24:1:001

Yang L, Zou J, Zhang M, Xu H, Qi W, Gao L, et al. The relationship between thyroid stimulating hormone within the reference range and coronary artery disease: Impact of age. Endocr J. 2013; 60(6):773-9. https://doi.org/10.1507/ endocrj.EJ12-0448 PMid:23470525

Thom T, Hasse N, Rosamond W. Heart disease and stroke statistics-2006 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006; 113:e85. https:// doi.org/10.1161/CIRCULATIONAHA.105.171600 PMid:16407573

Kreatsoulas Catherine, Sloane Debi, Pogue Janic, Velianou James L., Anand Sonia S. Referrals in acute coronary events for cardiac catheterization: The RACE CAR Trial. Can J Cardiol. 2010; 8:e290-e296. https://doi.org/10.1016/S0828- 282X(10)70436-0

Thom T, Hasse N, Rosamond W. Heart disease and stroke statistics-2006 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006; 113:e85. https://doi. org/10.1161/CIRCULATIONAHA.105.171600 PMid:1640 7573

Braverman LE, Cooper D. 7th ed. Wolters Kluwer Health. Werner & Ingbar’s The Thyroid: A Fundamental and Clinical Text; 2012.

Cappola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab. 2003; 88(6):2438- 44. https://doi.org/10.1210/jc.2003-030398 PMid:12788839

Taylor PN, Razvi S, Pearce SH, Dayan CM. Clinical review: A review of the clinical consequences of variation in thyroid function within the reference range. J Clin Endocrinol Metab. 2013; 98:3562-3571 https://doi.org/10.1210/jc.2013- 1315 PMid:23824418

Sahni M, Kumar R, Thakur S, Bhardwaj R. Clinical profile, risk factors and shortterm outcome of acute myocardial infraction in females: A hospital based study. Heart India. 2013; 173-7

Nanjappa V et al. Clinical profile and 30-day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease: A single-center observational study. Indian Heart J. 2016 Mar-Apr; 68(2):164-8. https://doi.org/10.1016/j.ihj.2015.08.006 PMid:27133325 PMCid:PMC4867941

Castelli WP, Kanel WB. Cardiovascular disease in women. Am J Obstet Gynecol. 1988; 138:1553. https://doi. org/10.1016/0002-9378(88)90189-5

Rana M, Pandey M, Devpura G. Study of risk factors for st segment elevation myocardial infarction and it’s correlation with thyroid functions profile. Ann Int Med Den Res. 2018; 4(2):ME53-55. https://doi.org/10.21276/ aimdr.2018.4.2.ME13

Stephen SA, Darney BG, Rosenfeld AG. Symptoms of Acute Coronary Syndrome in Women with Diabetes: An Integrative Review of the Literature. Heart Lung. 2008; 37:179-89. http://dx.doi.org/10.1016/j.hrtlng.2007.05.006 PMid:18482629

Culic V, Eterovic D, Miric D, Silic N. Symptom presentation of acute myocardial infarction: influence of sex, age, and risk factors. American Heart Journal. 2002; 144:1012-7. https://doi.org/10.1067/mhj.2002.125625 PMid:12486425

Jamee A, Abed Y, Jalambo MO. Gender difference and characteristics attributed to coronary artery disease in gazapalestine. Global Journal of Health Science. 2013; 5:51-6. https://doi.org/10.5539/gjhs.v5n5p51 PMid:23985106 PMCid:PMC4776843

Jousilahti P, Vartiainen E, Tiromilehto J, Puska P. Sex, age, cardiovascular risk factors, and coronary heart disease: A prospective follow up study of 14,786 middle aged men and women in Finland. Circulation. 1999; 99(9):1165-72. https://doi.org/10.1161/01.CIR.99.9.1165 PMid:10069784

Sowers JR. Diabetes mellitus and cardiovascular disease in women. Arch Intern Med. 1998; 158:617-621. https://doi. org/10.1001/archinte.158.6.617 PMid:9521226

Dhar M, Dwivedi S, Agarwal MP, Rajpal S. Clinical profile of coronary artery disease in women. Indian J Cardiology. 2006; 9:18-23.

Bettegowda S. Clinical profile of ischemic heart disease in women with special reference to the risk factors sch. J App Med Sci. 2014; 2(6C):3020-5.

Colditz GA, Bonita R, Stamfer MJ, Willet WC, Rosner B, Speizer FE, Hennekens CH. Cigarette smoking and risk of stroke in middle aged women. N Engl J Med. 1988; 318(15):937-41. https://doi.org/10.1056/ NEJM198804143181501 PMid:3352685

Kaul U, Dogra B, Manchanda SC, Wasir HS, Rajani M, Bhatia ML. Myocardial infarction in young Indian patients: Risk factors and coronary arteriographic profile. Am Heart J. 1986; 112(1):75-75. https://doi.org/10.1016/0002- 8703(86)90680-0