Effect of Subclinical Hyperthyroidsm on the Outcome of Coronary Artery Graft Bypass Surgery
Introduction: Subclinical hyperthyroidsm is associated with negative effects on cardiovascular system. We aimed to evaluate the association between pre-operative thyroid hormones and post-operative outcome in patients undergoing coronary artery by-pass graft (CABG) surgery. Methods: A hundred and eighty nine patients with isolated CABG surgery were included into the study. Patient’s clinical characteristics, surgical details and post-operative mortality and morbidities were recorded.Patients were divided into two groups according to their TSH level with cut-off point of 0,35 was assumed. Results: The first group consists of 16 patients (9%) with subclinical hyperthyroid (SH) and the second group includes 173 euthyroid patients. In post-operative period; the incidence of arrhythmia, renal failure and inotropy requirement were significantly higher in SH group (p<.0001, p: 0.0002 and p<.0001 respectively) The incidence of peri-operative mortality was similar between groups. (p: 0.0860). Lenght of stay in intesive care unit and overall were significantly higher in patients with SH (p: 0.0102 and p: 0.0004 respectively). Discussion and Conclusion: Pre-operative subclinical hyperthyroidsm didn’t effect peri-operative mortality but may lead to higher postoperative complications such as arrhythmia, renal failure and low cardiacoutput syndrome in patients undergoing CABG surgery.
Effect of Subclinical Hyperthyroidsm on the Outcome of Coronary Artery Graft Bypass Surgery
Introduction: Subclinical hyperthyroidsm is associated with negative effects on cardiovascular system. We aimed to evaluate the association between pre-operative thyroid hormones and post-operative outcome in patients undergoing coronary artery by-pass graft (CABG) surgery. Methods: A hundred and eighty nine patients with isolated CABG surgery were included into the study. Patient’s clinical characteristics, surgical details and post-operative mortality and morbidities were recorded.Patients were divided into two groups according to their TSH level with cut-off point of 0,35 was assumed. Results: The first group consists of 16 patients (9%) with subclinical hyperthyroid (SH) and the second group includes 173 euthyroid patients. In post-operative period; the incidence of arrhythmia, renal failure and inotropy requirement were significantly higher in SH group (p<.0001, p: 0.0002 and p<.0001 respectively) The incidence of peri-operative mortality was similar between groups. (p: 0.0860). Lenght of stay in intesive care unit and overall were significantly higher in patients with SH (p: 0.0102 and p: 0.0004 respectively). Discussion and Conclusion: Pre-operative subclinical hyperthyroidsm didn’t effect peri-operative mortality but may lead to higher postoperative complications such as arrhythmia, renal failure and low cardiacoutput syndrome in patients undergoing CABG surgery.
___
- Referans1- Parle JV, Maisonneuve P, Sheppard MC, Boyle P, Franklyn JA. Prediction of all-cause and cardiovascular mortality in elderly people from one low serum thyrotropin result: a 10-year cohort study. Lancet. 2001; 358(9285):861–865.Referans 2-Iervasi G Pingitore A, Landi P, Racitii M, Ripoli A, Scariattini M, L’Abbate A, Donato L.Low-T3 syndrome:a strong progostic predictor of death in patients with herat disease. Circulation. 2003, 11;107(5):708–13. Referans 3- Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008; 29(1):76–131Referans 4-Park, Y.J., Yoon, J.W., Kim, K.I. et al. Subclinical hypothyroidism might increase the risk of transient atrial fibrillation after coronary artery bypass grafting. Ann Thorac Surg. 2009; 87: 1846–1852Referans 5- Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA. 2004; 291(2):228–238.Referans 6- Parle JV, Maisonneuve P, Sheppard MC, Boyle P, Franklyn JA. Prediction of all-cause and cardiovascular mortality in elderly people from one low serum thyrotropin result: a 10-year cohort study. Lancet. 2001; 358(9285):861–865.Referans 7- Sawin CT, Geller A, Wolf PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med. 1994; 331(19):1249–1252.Referans 8- Kaptein EM. Thyroid function in renal failure. Contrib Nephrol. 1986;50:64–72Referans 9- Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med. 2001. February 15; 344 7: 501– 9Referans 10-Chu SH, Huang TS, Wang SS, Wang CJ. Thyroid hormon changes after cardiovascular surgery and clinical implications. Ann Thorac Surg 1991;52:791-6