Abstract
BackgroundSubclinical hypothyroidism (SCH) has recently been acknowledged as an independent risk factor for coronary artery disease (CAD). However, the characteristics of CAD in patients with SCH are not fully understood. This study aims to evaluate the features of CAD in patients with SCH using coronary computed tomographic angiography (CCTA).Materials and methodsFrom 1 April, 2018 to 30 June, 2020, 234 consecutive SCH patients with coronary plaques identified on CCTA were included retrospectively. They were further subdivided into different degree of SCH groups (mild SCH vs. moderate SCH vs. severe SCH: 143 vs 62 vs 28) and different gender groups (men with SCH vs. women with SCH:116 vs 118). The distributions and types of plaques, luminal narrowing, segment involvement scores (SIS) and segment stenosis scores (SSS) were evaluated and compared among the different groups.ResultsPatients with severe SCH had fewer calcified plaques (0.7 ± 0.9 vs. 2.0 ± 1.9, p < 0.001) and more non-calcified plaques (0.9 ± 1.0 vs. 0.3 ± 0.5, p < 0.001) than those with mild SCH. As the SCH condition worsened, the proportion of non-calcified plaques significantly increased. Whereas there were no significant discrepancies in SIS and SSS among patients with different grades of SCH (all p > 0.05). Men with SCH had higher SIS (3.9 ± 2.3 vs. 3.0 ± 2.3, p = 0.004) and SSS (7.8 ± 5.4 vs. 5.4 ± 3.0, p = 0.002) than women. Multivariate logistic and linear regression analysis demonstrated that grades of SCH (Moderate SCH, odds ratio [OR] 2.11; 95% CI 1.03–4.34, p = 0.042; severe SCH, OR: 10.00; 95% CI 3.82–26.20, p < 0.001, taken mild SCH as a reference) was independently associated with the presence of non-calcified plaques, whereas sex (B: 1.67; 95% CI 0.27–3.10, p = 0.009) was independently associated with SSS.ConclusionsSevere SCH is associated with non-calcified plaques, and men with SCH have higher total plaque burden than women. We suggest that it is important to evaluate for coronary plaque in SCH patients, especially those with severe SCH and men with SCH.
Highlights
Coronary artery disease (CAD) remains a leading cause of mortality worldwide and poses a great socioeconomic burden [1]
Multivariate logistic and linear regression analysis demonstrated that grades of Subclinical hypothyroidism (SCH) (Moderate SCH, odds ratio [Odds ratio (OR)] 2.11; 95% CI 1.03–4.34, p = 0.042; severe SCH, OR: 10.00; 95% CI 3.82–26.20, p < 0.001, taken mild SCH as a reference) was independently associated with the presence of non-calcified plaques, whereas sex (B: 1.67; 95% CI 0.27–3.10, p = 0.009) was independently associated with stenosis scores (SSS)
Severe SCH is associated with non-calcified plaques, and men with SCH have higher total plaque burden than women
Summary
Coronary artery disease (CAD) remains a leading cause of mortality worldwide and poses a great socioeconomic burden [1]. Subclinical hypothyroidism (SCH) is an early, mild form of hypothyroidism, which is defined as elevated of thyroid-stimulating hormone (TSH) with a normal level of free thyroxine (FT4) level [4]. The incidence of SCH in the iodine-sufficient population is about 10% and increases with age. The incidence rate of SCH is higher in women than men [4]. Subclinical hypothyroidism (SCH) has recently been acknowledged as an independent risk factor for coronary artery disease (CAD). The characteristics of CAD in patients with SCH are not fully understood. This study aims to evaluate the features of CAD in patients with SCH using coronary computed tomographic angiography (CCTA)
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