Evaluation of Subclinical Hypothyroidism in Patients with Acute Coronary Syndrome: An Institutional Based Study

Background: Subclinical hypothyroidism (SCH) refers tosubjects who have an elevated thyroid-stimulating hormonelevel and a normal free thyroxine level. The subclinicalhypothyroidism is associated with increased risk ofcardiovascular morbidities. The present study was conductedto assess prevalence of subclinical hypothyroidism of patientswith acute coronary syndrome (ACS).Materials and Methods: The present study was a prospectivestudy carried out among 400 patients from the attendants ofDepartment of Medicine, Heritage Institute of MedicalSciences, Varanasi, Uttar Pradesh, India. Complete anddetailed medical history, full clinical examination was collected.Two-dimensional echocardiography and Doppler examinationwere performed for all patients. Venous blood samples wereobtained from all patients on arrival for serum cardiac markers,liver and kidney functions, lipid profile and thyroid profile wasmeasured. Data was collected and analysis were performedusing SPSS program; version 21. A p value of ≤ 0.05considered as being statistically significant.Results: In the present study total patients included in thestudy were 400 in which patients below 60 years were 38.75%and above 60 years were 61.25%. The male and female were50% each. 65% patients were hypertensive, 61.25% werediabetic, 60% were current smokers, 15% had family history ofpremature CAD, 20% presented by STEMI, 23.5% presentedby NSTEMI and 37.5% presented by UA. The euthyroid statuswas the most prevalent among the patients 80% whilesubclinical hypothyroidism represents only 6%. According toage, prevalence of SCH was more in patients who are belowage of sixty, and according to gender, prevalence of SCH wasmore in females while according to the type of ACS,prevalence of SCH was 45.83% in patients presented by UAvs. 54.16% in those presented by MI and it was 25% inpatients presented by ST elevation ACS and 75% patients inthose presented by Non-ST elevation ACS.Conclusion: This study concluded that prevalence ofsubclinical hypothyroidism was 6%. The prevalence of SCHwas more in patients who are above age of sixty and infemales while according to the type of ACS, prevalence of SCHwas more in patients presented by MI and in patients thosepresented by Non-ST elevation ACS.