Incidence degree and clinical significance of first detected hypothyroidia in patients with ST-segment elevation myocardial infarction


DOI: https://dx.doi.org/10.18565/therapy.2024.4.82-90

Gridneva Yu.Yu., Chesnikova A.I., Safronenko V.A., Edlenko E.V., Zatloukal M.Yu.

1) Rostov State Medical University of the Ministry of Healthcare of Russia, Rostov-on-Don; 2) Rostov Regional Clinical Hospital, Rostov-on-Don
Abstract. Hypothyroidism is a marker of adverse in-hospital events and increased mortality in patients with acute coronary syndrome (ACS). Normally thyroid function assessment is not routinely performed in clinical practice during hospitalization of patients with ACS, and therefore the presence of hypothyroidism is often not detected.
The aim: to assess the incidence of newly diagnosed subclinical and manifest hypothyroidism in patients with ST-segment elevation myocardial infarction (STEMI) and to determine the clinical features of this comorbidity.
Material and methods. In all patients with STEMI, the level of thyroid-stimulating hormone (TSH) was identified, and thyroid function was assessed in case the TSH level deviated from the norm. Stage I of the study included 415 patients, stage II included 130 patients with STEMI. Depending on the presence of newly diagnosed hypothyroidism, participants were divided into 3 groups: the 1st group included individuals without hypothyroidism syndrome (n = 57), 2A group – patients with subclinical hypothyroidism (n = 42) and 2B group – patients with manifest hypothyroidism (n = 31). All of them were examined for concomitant pathology, medical history, clinical symptoms and complications in the acute period of MI.
Results. Newly diagnosed hypothyroidism occurred in 27.5% of patients with STEMI: subclinical hypothyroidism - in 19.8%, manifest hypothyroidism – in 7.7% of cases. In patients with concomitant manifest hypothyroidism a more frequent occurrence of supraventricular cardiac arrhythmias (p < 0.05) took place. According to the TIMI scale, in the acute period of MI, higher scores were recorded in patients with manifest hypothyroidism (p < 0.05).
Conclusion. A high incidence of newly diagnosed hypothyroidism was recorded in patients with STEMI (27.5% of cases). During hospitalization period, patients with STEMI in the presence of manifest hypothyroidism developed statistically significantly more often supraventricular heart rhythm disturbances, also they had a higher risk of cardiovascular complications developing in the acute period of MI according to the TIMI scale.
Keywords: anamnestic peculiarities, subclinical and manifest hypothyroidism, clinical manifestations, myocardial infarction, coronary heart disease
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About the Autors

Yulia Yu. Gridneva, MD, postgraduate student of the Department of internal medicine No. 1, Rostov State Medical University of the Ministry of Healthcare of Russia, cardiologist at the Department of cardiology No. 1, Rostov Regional Clinical Hospital. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
E-mail:gridulyayalia@mail.ru
ORCID: https://orcid.org/0000-0002-8331-945X
Anna I. Chesnikova, MD, Dr. Sci. (Medicine), professor, head of the Department of internal medicine No.1, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
E-mail: rostov-ossn@yandex.ru
ORCID: https://orcid.org/0000-0002-9323-592X
Victoria A. Safronenko, MD, PhD (Medicine), associate professor of the Department of Internal medicine No. 1, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
E-mail: v.chugunova@mail.ru
ORCID: https://orcid.org/0000-0002-6965-5019
Elena V. Edlenko, MD, ultrasound diagnostics doctor at the Department of ultrasound diagnostics, Rostov Regional Clinical Hospital. Address: 344015, Rostov-on-Don, 170 Blagodatnaya St.
E-mail: edlenko74@mail.ru
ORCID: https://orcid.org/0009-0006-3234-8695
Marina Yu. Zatloukal, MD, doctor of ultrasound diagnostics at the Department of ultrasound diagnostics, Rostov Regional Clinical Hospital. Address: 344015, Rostov-on-Don, 170 Blagodatnaya St.
E-mail: Zatloukal-m-67@mail.ru
ORCID: https://orcid.org/0009-0006-4268-9928


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