Long-term effect of a large dose of iodinated contrast in patients with mild thyroid dysfunction: a prospective cohort study.
10.1097/CM9.0000000000002260
- Author:
Hailong SI
1
;
Kangyin CHEN
1
;
Qin QIN
2
;
Yuanyuan LIU
3
;
Bingrang ZHAO
2
Author Information
1. Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
2. Department of Cardiovascular Disease, Tianjin Chest Hospital, Tianjin 300051, China.
3. Comprehensive Disease Center, Tianjin Chest Hospital, Tianjin 300051, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Contrast Media/adverse effects*;
Prospective Studies;
Hypothyroidism;
Triiodothyronine;
Iodine/adverse effects*;
Thyrotropin;
Thyroxine
- From:
Chinese Medical Journal
2023;136(17):2044-2049
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:More than 75 million procedures with intravascular iodine-based contrast media (ICM) are performed worldwide every year, and some patients undergoing these procedures do not have normal thyroid function. The long-term effects of ICM in patients with mild thyroid dysfunction (TD) are unclear.
METHODS:This prospective cohort study was conducted in China. Patients with stable angina pectoris with total triiodothyronine (TT3) reduction, normal thyroid-stimulating hormone, and reverse triiodothyronine (rT3) were enrolled and divided into high-dose (≥100 mL ICM) and low-dose groups (<100 mL ICM). We dynamically investigated the trends in thyroid function, rT3, and thyroid antibodies one year after ICM exposure.
RESULTS:A total of 154 patients completed 6 months of follow-up and 149 completed 1 year of follow-up. Thyroglobulin antibody (TGAB) levels were elevated in 41 (26.6%) patients before ICM exposure, 11 (7.1%) of whom also had elevated thyroid peroxidase antibody levels. Transient subclinical TD occurred 6 months after ICM exposure; 75.5% (34/45) of post-operative TD occurred in the high-dose group. One patient developed severe hypothyroidism with myxedema, requiring drug intervention 1 year after ICM exposure. The level of rT3 showed no statistically significant changes during post-operative follow-up ( P = 0.848). The TGAB level decreased at 6th month ( P < 0.001), but increased at 1 year after ICM exposure ( P = 0.002).
CONCLUSIONS:Patients with T3 reduction are at a risk of transient subclinical TD and hypothyroidism after a single large dose of ICM. Follow-up of this population at 9-12 months after ICM exposure is warranted.
