Session: SUN 414-431-HPT Axis Biology
Poster Board SUN-421
Methods: We examined 2507 subjects out of 3316 with angiographic proven CAD and matched controls in which CAD had been ruled out by angiography. Subjects with overt thyroid disease and those receiving thyroid medication and those with medication with direct influence on thyroid metabolism were excluded. Only data of those subjects who had a full set of thyroid hormones were included.Eligible Subjects were classified into quartiles for TSH, fT4 and fT3 levels. We used the COX proportional hazards model to examine the association between thyroid hormone levels and mortality from all causes and cardiovascular causes. Multivariable adjustments were also carried out.
Results: Our findings show that patients with ft4 levels over 18 pmol/L, defined as the highest fT4 quartile, have the highest mortality from all causes: HR 1.52 and also from cardiovascular causes: HR 1.77. Ref Value HR 1.00, lowest quartile.
Patients with fT3 Levels in the lowest quartile (1.1-4.2 pmol/L), HR 1.00, reference Value, have the highest mortality risk from all causes as well as from cardiovascular causes with constantly decreasing HRs up to the forth quartile with fT3 ≥5.4 pmol/L. HR from all causes 0.54 (CI 95% 0.44-0.67). HR from cardiovascular causes 0.47( CI 95% 0.36-0.61).These findings were robust against adjustment for age and sex. TSH showed no correlation with all cause mortality or cardiovascular events.
Discussion: High fT4 and low fT3 levels in thyroid healthy Caucasians undergoing angiography independently predict mortality from cardiovascular causes and from all causes. The results underline the importance of fT4 and fT3 levels in the risk evaluation of long time total and cardiovascular mortality of ACS patients without thyroid disorders or thyroid treatment. To our surprise TSH did not show any association with long term mortality, not even in the unadjusted statistic models. The reason for this is still unknown. Recent studies have demonstrated that low TSH is not associated with long term mortality.
Conclusion:: Free thyroid hormones, but not TSH, predict long term mortality risk in Caucasians without thyroid disease.
Nothing to Disclose: AM, JM, WM
*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm
See more of: Abstracts - Orals, Featured Poster Presentations, and Posters