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Subclinical hypothyroidism increases mortality after myocardial infarction

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NEW ORLEANS — Long-term mortality after an event of ST-elevation myocardial infarction is higher for adults with subclinical hypothyroidism vs. those without, according to findings presented at the Endocrine Society Annual Meeting.

Elena Izkhakov

“These findings are important because the prevalence of [subclinical hypothyroidism] increases with age and ranges from 3% to 8% in the total population. Unfortunately, thyroid function tests are not taken routinely during hospitalization,” Elena Izkhakov, MD, PhD, of the Tel Aviv Sourasky Medical Center told Endocrine Today. “Additionally, the threshold of TSH to define and to treat [subclinical hypothyroidism] remains controversial. Future prospective study should clarify the optimal treatment for this group of patients.”

Izkhakov and colleagues assessed thyroid-stimulating hormone and thyroxine levels of 1,593 patients who experienced STEMI and were treated with a primary care intervention at the center’s coronary care unit from January 2008 to August 2017. No patients in the cohort had previously been diagnosed with hypothyroidism or treated with thyroid replacement.

Among this cohort, 4.2% had subclinical hypothyroidism, which was defined as a TSH level of 5 mU/mL or more together with normal free T₄ level. The researchers then evaluated 30-day (short-term) and 1-year (long-term) mortality in this population and found that subclinical hypothyroidism had an independent association with short-term (P = .02) and long-term (P = .007) rates, with the latter finding based on a multivariable Cox regression model. In addition, patients with subclinical hypothyroidism had higher mortality rates at 1 year compared with those without the condition (24% vs. 13%; P < .001), the researchers reported. – by Phil Neuffer

Reference:

Izkhakov E, et al. SAT-LB014. Subclinical hypothyroidism and all-cause mortality among patients with myocardial infarction. Presented at: The Endocrine Society Annual Meeting; March 23-26, 2019; New Orleans.

Disclosures: The authors report no relevant financial disclosures.