The Impact of Subclinical Hypothyroidism or Thyroid Autoimmunity on Coronary Vasospasm in Patients without Associated Cardiovascular Risk Factors.
10.4070/kcj.2015.45.2.125
- Author:
Sea Won LEE
1
;
Kyoung Im CHO
;
Hyun Su KIM
;
Jung Ho HEO
;
Tae Joon CHA
Author Information
1. Division of Cardiology, Department of Internal Medicine, Busan Veterans Hospital, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Hypothyroidism;
Autoimmunity;
Coronary vasopasm
- MeSH:
Autoimmunity*;
Body Mass Index;
Coronary Angiography;
Coronary Vasospasm*;
Coronary Vessels;
Ergonovine;
Humans;
Hyperthyroidism;
Hypothyroidism*;
Iodide Peroxidase;
Logistic Models;
Odds Ratio;
Risk Factors*;
Spasm;
Thyroid Gland*
- From:Korean Circulation Journal
2015;45(2):125-130
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Subclinical hypothyroidism is associated with endothelial dysfunction and impaired coronary flow reserve. However, the effect of subclinical hypothyroidism or thyroid autoimmunity on variant angina has yet to be determined. SUBJECTS AND METHODS: Among 385 consecutive patients without associated cardiovascular risk factors who underwent coronary angiography with the ergonovine provocation test (EPT), 165 had a positive EPT {EPT(+)} and 220 had a negative EPT {EPT(-)}. The relationship between coronary artery spasm and the presence of subclinical thyroid dysfunction as well as serum thyroid peroxidase autoantibody (TPO Ab) was evaluated. RESULTS: The proportion of patients with subclinical hypothyroidism among those who were EPT(+) was significantly higher than that in those who were EPT(-) (18% vs. 11%, p=0.001). However, there was no significant difference in the proportion of patients with subclinical hyperthyroidism between the groups. Moreover, EPT(+) patients showed significantly more positive TPO Ab (33% vs. 14%, p<0.001) than those with EPT(-). There was a positive correlation between EPT(+) and TPO positivity (r=0.226, p<0.001), subclinical hypothyroidism (r=0.112, p=0.033), and body mass index (r=0.123, p=0.018). Binary logistic regression analysis revealed that the significant predictors of EPT(+) were body mass index {adjusted odds ratio (OR)=1.042, 95% confidence interval (CI)=1.005-1.080}, presence of subclinical hypothyroidism (OR=3.047, 95% CI=1.083-8.572), TPO Ab titer (OR=1.028, 95% CI=1.015-1.041), and the presence of TPO Ab (OR=4.904, 95% CI=1.544-15.567). CONCLUSION: Subclinical hypothyroidism and the presence of TPO Ab are significantly associated with coronary vasospasm in patients without cardiovascular risk factors.
