Study About Influence Of Thyroid-stimulating Hormone Within Reference Range On Patients With CHD After PCI

ObjectiveThis sturdy observed clinical baseline datas from patients with coronary heart disease whose thyroid-stimulating hormone(TSH)within reference range accepting percutaneous coronary intervention(PCI),and followsed above patients one year about their healthy conditions.We aimed to observe the prognosis value of thyroid-stimulating hormone in reference range in patients with CHD after PCI and its clinical significance.MethodsWe selected patients whosaw doctors in cardiovascular department,Third Military Medical University of Chinese PLA,xinqiao hospital affiliated from January 1st,2014,to January 1st,2015.We were according to the following two standards.First,their TSH were in in the normal range(0.3 μIU/ml-4.2 μIU/ml).What s more,they were all accepting PCI.Finally,one thousand and two patients with coronary heart disease were enrolled.According to the thyroid-stimulating hormone level,patients were divided into three groups: the first group(TSH: 0.30 μIU/ml-1.60 μIU/ml,387 patients),the second group(TSH 1.61 μIU/ml-2.90 μIU/ml),the third group(TSH: 2.91 μIU/ml-4.20 μIU/ml).We carried out one year follow-up,recording all-cause motality.Peri-PCI bleeding and readmission as the primary end points.ResultsThe first group totally experienced six events of all-cause mortality in one year follow up,with all-cause mortality rate of 1.55%;The second group finnally occurred eight events of all-cause mortality in one year follow up,with all-cause mortality rate of 1.94%,The third group happened ten events of all-cause mortality in one year follow up,with all-cause mortality rate of 4.95%.There were significant differences in one-year all-cause mortality among the above three groups(all P<0.05),The first group totally experienced 13 peri-PCI bleedingevents in one year follow up,with the peri-PCI bleeding rate of 3.36%;The second group finnally occurred 14 peri-PCI bleeding events in one year follow up,with a peri-PCI bleeding rate of 3.39%;The third group happened 16 peri-PCI bleeding events in one year follow up,with a peri-PCI bleeding rate of 7.92%;Similarly,There were great differences in one-year peri-PCI bleeding among the three groups(all P<0.05);The first group experienced 38 events of readmission in one year follow up,with a readmission rate of 9.82%;The second group finnally occurred 27 events of readmission in one year follow up,with a readmission rate of 6.54%,The third group happened 15 events of readmission in one year follow up,with a readmission rate of 7.43%.There were no significant differences in one-year all-cause mortality among the above three groups(all P>0.05);Logistic regression analysis indicated that TSH in the upper reference range was a risk factor of one-year all-cause mortality(OR=1.484,P<0.05)and peri-PCI bleeding(OR=1.466,P<0.05).Survival analysis also showed that TSH in the upper reference range was a risk factor of one-year all-cause mortality(RR=1.566,P<0.05).ConclusionFrom the sturdy,we can saw that within reference range,the level of the thyroidstimulating hormone(TSH)higher,the rate of all-cause motality or peri-PCI bleeding higher.And,TSH level in the upper reference range is an independence risk factorin one-year all-cause motality and peri-PCI bleeding in patients with CHD after PCI.