Gut · 2006
Percutaneous gall bladder aspiration as an alternative to laparoscopic cholecystectomy in Child-Pugh C cirrhotic patients with acute cholecystitis.
Письмо в редакциюНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
He Tingting, Yang Peiyou, Ni Jin, Liu Yu, Niu Na, Ma Junpeng, Jiao Yang, Fan Tielong
Аннотация
OBJECTIVE: Subclinical hypothyroidism (SCH) is associated with an increased risk of coronary heart disease (CHD), yet its predictive value for the severity of coronary artery lesions remains unclear. This study aimed to investigate the relationship between SCH and the Gensini score, a quantitative measure of coronary artery lesion severity, in patients with CHD.
METHODS: A retrospective single-center study was conducted involving 311 patients with CHD confirmed by coronary angiography, including 166 with SCH (TSH>4.5 mIU/L with normal FT3/FT4) and 165 euthyroid controls. The Gensini score was assessed by blinded cardiologists. Thyroid function parameters (TSH, FT3, FT4) and traditional cardiovascular risk factors were analyzed. Statistical analyses included Spearman correlation, multiple linear regression, and ROC curve analysis.
RESULTS: Patients with SCH had significantly higher median Gensini scores than controls (46 vs. 15, P<0.0001). TSH was strongly positively correlated with the Gensini score (ρ=0.837, P<0.0001). Multiple regression confirmed that SCH independently predicted higher Gensini scores after adjusting for traditional risk factors (β=0.168, P<0.001). ROC analysis showed that SCH status alone had an AUC of 0.968 for predicting high-risk lesions (Gensini ≥40), with an optimal TSH cutoff of >5.8 mIU/L (sensitivity 85%, specificity 83%). The combined model including SCH and traditional factors further improved predictive performance (AUC=0.906, NRI=17.3%, P=0.002).
CONCLUSION: SCH is independently associated with more severe coronary artery lesions in CHD patients, as quantified by the Gensini score. TSH>5.8 mIU/L may serve as a valuable threshold for identifying high-risk patients. Incorporating thyroid function screening into CHD risk assessment could enhance stratification and guide early intervention.
METHODS: A retrospective single-center study was conducted involving 311 patients with CHD confirmed by coronary angiography, including 166 with SCH (TSH>4.5 mIU/L with normal FT3/FT4) and 165 euthyroid controls. The Gensini score was assessed by blinded cardiologists. Thyroid function parameters (TSH, FT3, FT4) and traditional cardiovascular risk factors were analyzed. Statistical analyses included Spearman correlation, multiple linear regression, and ROC curve analysis.
RESULTS: Patients with SCH had significantly higher median Gensini scores than controls (46 vs. 15, P<0.0001). TSH was strongly positively correlated with the Gensini score (ρ=0.837, P<0.0001). Multiple regression confirmed that SCH independently predicted higher Gensini scores after adjusting for traditional risk factors (β=0.168, P<0.001). ROC analysis showed that SCH status alone had an AUC of 0.968 for predicting high-risk lesions (Gensini ≥40), with an optimal TSH cutoff of >5.8 mIU/L (sensitivity 85%, specificity 83%). The combined model including SCH and traditional factors further improved predictive performance (AUC=0.906, NRI=17.3%, P=0.002).
CONCLUSION: SCH is independently associated with more severe coronary artery lesions in CHD patients, as quantified by the Gensini score. TSH>5.8 mIU/L may serve as a valuable threshold for identifying high-risk patients. Incorporating thyroid function screening into CHD risk assessment could enhance stratification and guide early intervention.