Evaluation of thyroid dysfunction in acute coronary syndrome.

ABSTRACT

Background & Objectives: 1} To describe thyroid hormone profile in patients with acute coronary syndromes (ACS) 2} To find, If any, short term prognostic significance of Thyroid diseases. Materials & Methods The study has been carried out at Shree Sayajirao General Hospital and Medical College Baroda during period of March 2011 to May 2012. The study comprised of patients with acute coronary syndrome admitted in ICCU of SSG, Hospital. Inclusion criteria were patients with acute coronary syndrome, irrespective of gender, race, ethnic group, age, and clinical severity, giving consent for being included as a part of the study. Exclusion criteria included patients using corticosteroids, amiodarone, or thyroid disease drugs, who had received any iodinated contrast agent within the previous two weeks, Patients with established diseases, such as neoplasias, chronic renal failure, chronic obstructive pulmonary disease requiring antibiotic therapy, liver cirrhosis, active infection, and decompensated diabetes mellitus, conditions that are known to affect thyroid function tests. Results: Of total 30 pts of STEMI, 30 % had increased level of Free T4 on day 0 and 23.07% had increased values on day 4. Of total 30 pts of NSTEMI/UA, 20 % had increased level of Free T4 on day 0 and 14.28% had increased values on day 4. The levels of TSH, free and Total T3 as well as Total T4 were not significantly different in either STEMI/NSTEMI group either Day 0 or Day 4. 21.67% of pts had evidence of Sick Euthyroid Syndrome on day of admission. Of the total 6 pts expired before day 4, 3 patients had evidence of Sick Euthyroid Syndrome at the time of admission. The association of Sick Euthyroid syndrome was found to be significant for mortality in patients of STEMI with 3 out of 4 expired patients of STEMI having SES at the of admission with significant p value {p <0.05} .There was no significant difference in mortality in patients of NSTEMI/UA having SES. Conclusion: Our results show the importance of recognizing the “Euthyroid Sick Syndrome” in coronary heart disease patients, suggesting an association with poorer prognosis in patients with ST elevated Myocardial Infarction in form of increased mortality and no association was found with mortality in patients having Non ST elevated Myocardial Infarction or Unstable Angina.