SAT-LB014 Subclinical Hypothyroidism and All-cause Mortality among Patients with Myocardial Infarction

Abstract

Introduction: Subclinical hypothyroidism (SCH) is defined as an elevated serum thyroid-stimulating hormone (TSH) level with a normal serum free thyroxine level (FT4). The aim of this study was to investigate the association between SCH and short and long term all-cause mortality in a large cohort of patients with ST elevation myocardial infarction (STEMI). Methods: We evaluated TSH and FT4 levels of 1593 STEMI patients without known history of hypothyroidism or thyroid replacement treatment who were admitted to the coronary care unit and underwent primary PCI between January 2008 and August 2017. The presence of SCH was defined as TSH levels ≥5 mU/ml in the presence of normal free T4 levels. Patients were assessed for short (30 days) and long term (1 year) outcomes. Results: The presence of SCH was demonstrated in 68/1593 (4.2%) of STEMI patients. Patients with SCH had lower left ventricular ejection fraction, older age (more than 60), family history of CAD and were associated independently with 30-day mortality (OR 3.24, 95% CI: 1.22-8.63, p=0.02). Long term mortality was significantly higher among those with SCH (16/68 24 %) than those without SCH (202/1525, 13 %; p<0.001). Following the performance of multivariable cox regression model, SCH was independently associated with long term mortality following STEMI (HR 2.17, 95% CI:1.24-3.79, p=0.007). Conclusions: Among STEMI patients treated with primary coronary intervention the presence of SCH is common and may serve as a significant marker for higher short and long term mortality. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.