{"title":"亚临床甲状腺功能减退对冠心病患者凝血参数及冠心病严重程度的影响","authors":"Wei Guo, Li-Yuan Hou, Xin Yi","doi":"10.1159/000545904","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the effect of subclinical hypothyroidism (SCH) on coagulation parameters and the progression of coronary artery disease (CAD) in patients with coronary heart disease (CHD).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 452 patients who were diagnosed with CHD through coronary angiography between January 2020 and December 2021 at the Department of Cardiology, Jining First People's Hospital. The patients were divided into three groups based on thyroid-stimulating hormone (TSH) levels: a normal thyroid function group (244 cases), a mild SCH group (162 cases), and a severe SCH group (46 cases). General demographic data, coagulation parameters, number of affected coronary vessels, stenosis location, and stenosis severity were compared across the groups.</p><p><strong>Results: </strong>(1) Significant differences were observed among the three groups in terms of sex, age, TSH, free triiodothyronine (FT3), free thyroxine (FT4), triglycerides, total cholesterol, low-density lipoprotein cholesterol, fibrinogen, prothrombin time, activated partial thromboplastin time, D-dimer, mean platelet volume, and platelet distribution width (P < 0.05). (2) The Gensini scores were 27 (17, 43.88) for the normal thyroid function group, 37.5 (25, 52.25) for the mild SCH group, and 48 (32.88, 73.75) for the severe SCH group, showing statistically significant differences (P < 0.05). (3) There was a positive correlation between Gensini score and TSH (r = 0.243, P < 0.05) and negative correlations between Gensini score and both FT3 (r = -0.139, P < 0.05) and FT4 (r = -0.12, P < 0.05). (4) TSH level, hypertension history, and lipoprotein(a) were identified as risk factors for Gensini score (P < 0.05).</p><p><strong>Conclusion: </strong>Patients with CHD and SCH present a hypercoagulable state and an elevated risk of thrombosis. TSH levels are linked to the severity of coronary artery stenosis, underscoring the importance of early thyroid function testing in patients with CHD to inform treatment decisions.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-19"},"PeriodicalIF":1.9000,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Subclinical Hypothyroidism on Coagulation Parameters and Coronary Artery Disease Severity in Patients with Coronary Heart Disease.\",\"authors\":\"Wei Guo, Li-Yuan Hou, Xin Yi\",\"doi\":\"10.1159/000545904\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study evaluated the effect of subclinical hypothyroidism (SCH) on coagulation parameters and the progression of coronary artery disease (CAD) in patients with coronary heart disease (CHD).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 452 patients who were diagnosed with CHD through coronary angiography between January 2020 and December 2021 at the Department of Cardiology, Jining First People's Hospital. The patients were divided into three groups based on thyroid-stimulating hormone (TSH) levels: a normal thyroid function group (244 cases), a mild SCH group (162 cases), and a severe SCH group (46 cases). General demographic data, coagulation parameters, number of affected coronary vessels, stenosis location, and stenosis severity were compared across the groups.</p><p><strong>Results: </strong>(1) Significant differences were observed among the three groups in terms of sex, age, TSH, free triiodothyronine (FT3), free thyroxine (FT4), triglycerides, total cholesterol, low-density lipoprotein cholesterol, fibrinogen, prothrombin time, activated partial thromboplastin time, D-dimer, mean platelet volume, and platelet distribution width (P < 0.05). (2) The Gensini scores were 27 (17, 43.88) for the normal thyroid function group, 37.5 (25, 52.25) for the mild SCH group, and 48 (32.88, 73.75) for the severe SCH group, showing statistically significant differences (P < 0.05). (3) There was a positive correlation between Gensini score and TSH (r = 0.243, P < 0.05) and negative correlations between Gensini score and both FT3 (r = -0.139, P < 0.05) and FT4 (r = -0.12, P < 0.05). (4) TSH level, hypertension history, and lipoprotein(a) were identified as risk factors for Gensini score (P < 0.05).</p><p><strong>Conclusion: </strong>Patients with CHD and SCH present a hypercoagulable state and an elevated risk of thrombosis. TSH levels are linked to the severity of coronary artery stenosis, underscoring the importance of early thyroid function testing in patients with CHD to inform treatment decisions.</p>\",\"PeriodicalId\":9391,\"journal\":{\"name\":\"Cardiology\",\"volume\":\" \",\"pages\":\"1-19\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-04-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000545904\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000545904","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨亚临床甲状腺功能减退症（SCH）对冠心病（CHD）患者凝血参数及冠心病（CAD）进展的影响。方法：回顾性分析济宁市第一人民医院心内科2020年1月至2021年12月通过冠状动脉造影诊断为冠心病的452例患者。根据促甲状腺激素（TSH）水平将患者分为三组：甲状腺功能正常组（244例）、轻度SCH组（162例）和重度SCH组（46例）。比较各组的一般人口学数据、凝血参数、受影响冠状动脉数量、狭窄位置和狭窄严重程度。结果：(1)三组患者在性别、年龄、TSH、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、纤维蛋白原、凝血酶原时间、活化部分凝血活酶时间、d -二聚体、平均血小板体积、血小板分布宽度等指标上差异均有统计学意义（P < 0.05）。(2)甲状腺功能正常组Gensini评分为27分（17分，43.88分），轻度SCH组为37.5分（25分，52.25分），重度SCH组为48分（32.88分，73.75分），差异均有统计学意义（P < 0.05）。(3) Gensini评分与TSH呈正相关（r = 0.243, P < 0.05），与FT3评分呈负相关（r = -0.139, P < 0.05），与FT4评分呈负相关（r = -0.12, P < 0.05）。(4) TSH水平、高血压病史、脂蛋白(a)是Gensini评分的危险因素（P < 0.05）。结论：冠心病合并SCH患者存在高凝状态，血栓形成风险增高。TSH水平与冠状动脉狭窄的严重程度有关，强调了冠心病患者早期甲状腺功能检测对指导治疗决策的重要性。
Impact of Subclinical Hypothyroidism on Coagulation Parameters and Coronary Artery Disease Severity in Patients with Coronary Heart Disease.
Objective: This study evaluated the effect of subclinical hypothyroidism (SCH) on coagulation parameters and the progression of coronary artery disease (CAD) in patients with coronary heart disease (CHD).
Methods: A retrospective analysis was conducted on 452 patients who were diagnosed with CHD through coronary angiography between January 2020 and December 2021 at the Department of Cardiology, Jining First People's Hospital. The patients were divided into three groups based on thyroid-stimulating hormone (TSH) levels: a normal thyroid function group (244 cases), a mild SCH group (162 cases), and a severe SCH group (46 cases). General demographic data, coagulation parameters, number of affected coronary vessels, stenosis location, and stenosis severity were compared across the groups.
Results: (1) Significant differences were observed among the three groups in terms of sex, age, TSH, free triiodothyronine (FT3), free thyroxine (FT4), triglycerides, total cholesterol, low-density lipoprotein cholesterol, fibrinogen, prothrombin time, activated partial thromboplastin time, D-dimer, mean platelet volume, and platelet distribution width (P < 0.05). (2) The Gensini scores were 27 (17, 43.88) for the normal thyroid function group, 37.5 (25, 52.25) for the mild SCH group, and 48 (32.88, 73.75) for the severe SCH group, showing statistically significant differences (P < 0.05). (3) There was a positive correlation between Gensini score and TSH (r = 0.243, P < 0.05) and negative correlations between Gensini score and both FT3 (r = -0.139, P < 0.05) and FT4 (r = -0.12, P < 0.05). (4) TSH level, hypertension history, and lipoprotein(a) were identified as risk factors for Gensini score (P < 0.05).
Conclusion: Patients with CHD and SCH present a hypercoagulable state and an elevated risk of thrombosis. TSH levels are linked to the severity of coronary artery stenosis, underscoring the importance of early thyroid function testing in patients with CHD to inform treatment decisions.
期刊介绍：
''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.
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