Cardiology · 2025
Impact of Subclinical Hypothyroidism on Coagulation Parameters and Coronary Artery Disease Severity in Patients with Coronary Heart Disease.
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Guo Wei, Hou Li-Yuan, Yi Xin
Аннотация
INTRODUCTION: This study evaluated the effect of subclinical hypothyroidism (SCH) on coagulation parameters and the progression of coronary artery disease in patients with coronary heart disease (CHD).
METHODS: A retrospective analysis was conducted on 452 patients who were diagnosed with CHD through coronary angiography between January 2020 and December 2021 at the Department of Cardiology, Jining First People's Hospital. The patients were divided into three groups based on thyroid-stimulating hormone (TSH) levels: a normal thyroid function group (244 cases), a mild SCH group (162 cases), and a severe SCH group (46 cases). General demographic data, coagulation parameters, number of affected coronary vessels, stenosis location, and stenosis severity were compared across the groups.
RESULTS: (1) Significant differences were observed among the three groups in terms of sex, age, TSH, free tri-iodothyronine (FT3), free thyroxine (FT4), triglycerides, total cholesterol, low-density lipoprotein cholesterol, fibrinogen, prothrombin time, activated partial thromboplastin time, D-dimer, mean platelet volume, and platelet distribution width (p < 0.05). (2) The Gensini scores were 27 (17, 43.88) for the normal thyroid function group, 37.5 (25, 52.25) for the mild SCH group, and 48 (32.88, 73.75) for the severe SCH group, showing statistically significant differences (p < 0.05). (3) There was a positive correlation between Gensini score and TSH (r = 0.243, p < 0.05) and negative correlations between Gensini score and both FT3 (r = -0.139, p < 0.05) and FT4 (r = -0.12, p < 0.05). (4) TSH level, hypertension history, and lipoprotein(a) were identified as risk factors for Gensini score (p < 0.05).
CONCLUSION: Patients with CHD and SCH present a hypercoagulable state and an elevated risk of thrombosis. TSH levels are linked to the severity of coronary artery stenosis, underscoring the importance of early thyroid function testing in patients with CHD to inform treatment decisions.
METHODS: A retrospective analysis was conducted on 452 patients who were diagnosed with CHD through coronary angiography between January 2020 and December 2021 at the Department of Cardiology, Jining First People's Hospital. The patients were divided into three groups based on thyroid-stimulating hormone (TSH) levels: a normal thyroid function group (244 cases), a mild SCH group (162 cases), and a severe SCH group (46 cases). General demographic data, coagulation parameters, number of affected coronary vessels, stenosis location, and stenosis severity were compared across the groups.
RESULTS: (1) Significant differences were observed among the three groups in terms of sex, age, TSH, free tri-iodothyronine (FT3), free thyroxine (FT4), triglycerides, total cholesterol, low-density lipoprotein cholesterol, fibrinogen, prothrombin time, activated partial thromboplastin time, D-dimer, mean platelet volume, and platelet distribution width (p < 0.05). (2) The Gensini scores were 27 (17, 43.88) for the normal thyroid function group, 37.5 (25, 52.25) for the mild SCH group, and 48 (32.88, 73.75) for the severe SCH group, showing statistically significant differences (p < 0.05). (3) There was a positive correlation between Gensini score and TSH (r = 0.243, p < 0.05) and negative correlations between Gensini score and both FT3 (r = -0.139, p < 0.05) and FT4 (r = -0.12, p < 0.05). (4) TSH level, hypertension history, and lipoprotein(a) were identified as risk factors for Gensini score (p < 0.05).
CONCLUSION: Patients with CHD and SCH present a hypercoagulable state and an elevated risk of thrombosis. TSH levels are linked to the severity of coronary artery stenosis, underscoring the importance of early thyroid function testing in patients with CHD to inform treatment decisions.