Impact of free thyroxine levels and other clinical factors on bare metal stent restenosis
AUTOR(ES)
Canpolat, Uğur, Turak, Osman, Özcan, Fırat, Öksüz, Fatih, Mendi, Mehmet Ali, Yayla, Çağrı, Aydoğdu, Sinan
FONTE
Arch. Endocrinol. Metab.
DATA DE PUBLICAÇÃO
25/08/2016
RESUMO
ABSTRACT Objective Thyroid hormones have both direct and indirect effects on thermogenesis such as modulating vascular smooth muscle cell proliferation. However, the influence of more subtle changes in thyroid hormones on coronary atherosclerosis remains a matter of speculation. Smooth muscle cells play a crucial role in the pathogenesis of in-stent restenosis (ISR). However, the relationship between free thyroxine (fT4) and ISR has not been studied. In the present study, we aimed to assess the role of preprocedural serum fT4 level on the development of ISR in patients undergoing coronary bare metal stent (BMS) implantation. Materials and methods We enrolled and analyzed clinical, biochemical, and angiographic data from 705 consecutive patients without a history of primary thyroid disease [mean age 60.3 ± 9.3 years, 505 (72%) male]; all patients had undergone BMS implantation and further control coronary angiography owing to stable or unstable angina pectoris. Patients were divided into 3 tertiles based on preprocedural serum fT4 levels. Results ISR was observed in 53 (23%) patients in the lowest tertile, 82 (35%) patients in the second tertile, and 107 (46%) patients in the highest fT4 tertile (p < 0.001). Using multiple logistic regression analysis, five characteristics emerged as independent predictors of ISR: diabetes mellitus, smoking, HDL-cholesterol, stent length, and preprocedural serum fT4 level. In receiver operating characteristics curve analysis, fT4 level > 1.23 mg/dL had 70% sensitivity and 73% specificity (AUC: 0.75, p < 0.001) in predicting ISR. Conclusion Higher preprocedural serum fT4 is a powerful and independent predictor of BMS restenosis in patients with stable and unstable angina pectoris.
Documentos Relacionados
- Predictors of restenosis after percutaneous coronary intervention using bare-metal stents: a comparison between patients with and without dysglycemia
- Effects of stent sizing on endothelial and vessel wall stress: potential mechanisms for in-stent restenosis
- Prognostic impact of preprocedural C reactive protein levels on 6‐month angiographic and 1‐year clinical outcomes after drug‐eluting stent implantation
- Effect of thyroid-suppressive doses of triiodothyronine on thyroxine turnover and on the free thyroxine fraction
- EFFECTS OF TRIIODOTHYRONINE AND OTHER THYROXINE ANALOGUES ON THYROXINE-BINDING IN HUMAN SERUM 1