DYSLIPIDEMIA AND SEVERITY OF ATHEROSCLEROTIC CORONARY ARTERY DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROME AND SUBCLINICAL HYPOTHYROIDISM

Abstract

Objective: To assess the derangements in lipid metabolism and the severity of atherosclerotic disease of the coronary arteries in patients with the acute coronary syndrome (ACS) and subclinical hypothyroidism (SHT). Methods: 146 medical records of inpatients of working age with newly developed ACS and various thyroid hormonal statuses were analysed. The lipid profile, high-sensitivity C-reactive protein (hs-CRP), thyroid-stimulating hormone (TSH), and free thyroid hormones (free thyroxine, FT4, and free triiodothyronine, FT3) levels were investigated. Coronary angiography results were used to assess coronary atherosclerotic plaque burden. The study group comprised 67 patients with ACS and SHT (TSH level >4.0 mIU/l with normal thyroid hormone levels), and the control group included 79 ACS patients without thyroid hormonal abnormalities. The groups were matched for the presence of unhealthy habits, gender, age, and severity of arterial hypertension. Before admission to the hospital, patients did not receive preventive therapy for coronary artery disease (CAD) or hormone replacement therapy. Results: In SHT patients, in comparison with the group of patients with normal thyroid function, the proportion of individuals with type IIa hyperlipidemia was higher – 82.0% (n=55) and 46.8% (n=37), respectively (χ2=19.33; p<0.001). A medium strength direct correlation was established between laboratory confirmed SHT and atherogenic dyslipidemia (r=0.62; p<0.01), an increase in the level of hs-CRP (r=0.74; p<0.01), and multivessel CAD (r=0.58; p<0.05). Conclusion: In patients with CHT, the proportion of individuals with multivessel coronary artery stenosis is higher, and CAD occurs in the presence of hs-CRP and atherogenic dyslipidemia. Keywords: Acute coronary syndrome, coronary artery disease, atherosclerosis, hyperlipidemia, subclinical hypothyroidism, thyroid gland.