THYROID DYSFUNCTION IN ACUTE CORONARY SYNDROME AND ITS PROGNOSTIC IMPLICATIONS

Background: Thyroid disorders impact the cardiovascular system through direct and indirect mechanisms and are associated with a significantly increased risk of vascular morbidity and mortality. We undertook this study to evaluate the prevalence of thyroid dysfunction in patients with acute coronary syndrome (ACS) and to study the impact of thyroid dysfunction on morbidity and mortality among those patients during 1-year follow-up. Methods: We studied 303 consecutive hospitalized patients between March 2018-February 2021 with ACS to determine clinical and sub-clinical features of thyroid dysfunction and their effect on MACE at 1 year follow-up. They were subjected to full history, clinical examination, routine investigations, and estimation of TSH, FT4 and FT3. Results: The prevalence of thyroid dysfunction in acute coronary syndrome was19%and the majority had subclinical hypothyroidism 34 (11%), followed by overt hypothyroidism 20 (7%). Hyperthyroidism was uncommon (1.3%). There was a significant preponderance of females in the thyroid dysfunction group. The majority 136 (45%) of patients, had STEMI. MACE rates were higher in the thyroid dysfunction group as compared to euthyroid group (35.6% vs 25.8%). Likewise, the incidence of rehospitalization due to CV causes was significantly higher in the thyroid dysfunction group than in the euthyroid group (32.2% vs 19.7%; p=0.0374). Conclusion: Hypothyroidism is an important risk factor in ACS patients, especially women. A clear trend towards higher MACE is seen in thyroid dysfunction patients.