Thyroid hormone patterns in elderly patients undergoing elective coronary procedures

W. Nammas 1, M. Mostafa 2, I. Sabry 3, M. Abdel-Aziz 4, H. Kabil 5

1 Cardiology Department, 2 Department of Geriatric Medicine, 3 Endocrinology Department, and 4 Clinical Pathology Department; school of Medicine, Ain Shams University (Egypt). 5 Cardiology Department, school of Medicine, Banha University (Egypt)

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• Genetics

Background and Objectives: Thyroid dysfunction is common in the elderly. We sought to explore thyroid hormone patterns in a series of elderly patients undergoing elective coronary procedures and their relation to the extent of coronary artery disease.

Materials and Methods: We enrolled 81 consecutive elderly patients admitted to undergo elective diagnostic or interventional coronary procedures. Samples were collected for assay of free thyroxin, free tri-iodothyronine, thyroid stimulating hormone, anti-thyroglobulin and anti-thyroid peroxidase antibodies. According to the number of coronary arteries affected by significant stenosis (≥70% luminal obstruction), we classified patients into a group with insignificant coronary disease, another with single vessel disease, and a third group with multi-vessel disease.

Results: Forty one (50.6%) patients were euthyroid, two patients (2.5%) had subclinical hypothyroidism, and 12 (14.8%) had clinical hypothyroidism. Yet, neither subclinical nor clinical hypothyroidism was statistically different among the 3 groups, (p >0.05 for both). Additionally, 3 patients (3.7%) had subclinical, and 2 (2.5%) had clinical hyperthyroidism. Finally, 21 patients (25.9%) had sick euthyroid syndrome. Again, all were statistically similar between the study groups, (p >0.5 for all). Similarly, both anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies were statistically similar among the 3 groups (p >0.05 for both).

Conclusion: Thyroid hormone disturbances are quite frequent in elderly patients undergoing elective coronary procedures, chiefly in the form of a hypothyroid state. These data do not support that thyroid hormone patterns relate to the extent of coronary artery disease in the elderly.

Corresponding Author: Wail Nammas, MD; e-mail: wnammas@hotmail.com

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