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首页> 外文期刊>Clinical Endocrinology >Hyperthyroidism in patients with ischaemic heart disease after iodine load induced by coronary angiography: Long‐term follow‐up and influence of baseline thyroid functional status
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Hyperthyroidism in patients with ischaemic heart disease after iodine load induced by coronary angiography: Long‐term follow‐up and influence of baseline thyroid functional status

机译：冠状动脉血管造影碘载血糖患者缺血性心脏病患者的甲状腺功能亢进：基线甲状腺功能状态的长期随访

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Summary Objective To study the effect of a iodine load on thyroid function of patients with ischaemic heart disease ( IHD ) and the long‐term influence of unknown subclinical hyperthyroidism. Context Subclinical hyperthyroidism is considered an independent risk factors for cardiovascular morbidity of patients with IHD . They routinely undergo coronary angiography with iodine contrast media ( ICM ) which may induce or even worsen hyperthyroidism. Design A cross‐sectional study followed by a longitudinal study on patients with subclinical hyperthyroidism. Patients 810 consecutive IHD outpatients without known thyroid diseases or treatment with drugs influencing thyroid activity undergoing elective coronary angiography. Measurements We evaluated thyroid function either before and 1?month after ICM ; patients with thyrotoxicosis at baseline or after ICM were then followed up for 1?year. Results 58 patients had hyperthyroidism at baseline ( HB , 7.2%), independently associated to FT 4 levels, thyroid nodules and family history of thyroid diseases. After ICM , the prevalence of hyperthyroidism was 81 (10%). Hyperthyroidism after ICM was positively predicted by baseline fT 4 levels, thyroid nodules, age over 60, male gender, family history of thyroid diseases. Three months after ICM , 34 patients (4.2%) still showed hyperthyroidism (22 from HB , 13 treated with methimazole). One year after ICM , hyperthyroidism was still present in 20 patients (2.5%, all from HB , 13 treated). Conclusions The prevalence of spontaneous subclinical hyperthyroidism in IHD is surprisingly elevated and is further increased by iodine load, particularly in patients with thyroid nodules and familial history of thyroid diseases, persisting in a not negligible number of them even after one year.
机译：摘要目的探讨碘载​​荷对缺血性心脏病（IHD）患者甲状腺功能的影响及未知亚临床甲状腺功能亢进症的长期影响。背景亚临床甲状腺功能亢进被认为是IHD患者心血管发病率的独立危险因素。它们经常与碘对比介质（ICM）进行冠状动脉造影，这可能会诱导甚至恶化甲状腺功能亢进症。设计横断面研究，然后是亚临床甲状腺功能亢进患者的纵向研究。患者810例连续的IHD门诊患者没有已知的甲状腺疾病或用药物处理，影响甲状腺活性接受选修冠状动脉造影。测量我们在ICM之前和1个月中评估甲状腺功能;患有基线或ICM后甲状腺毒性的患者随访1年。结果58例患者在基线（HB，7.2％）的甲状腺功能亢进，与FT 4水平，甲状腺结节和甲状腺疾病的家族史独立相关。在ICM之后，甲状腺功能亢进的患病率为81（10％）。 ICM后甲状腺功能亢进因基线FT 4水平，甲状腺结节，60岁以上，男性性别，甲状腺疾病家族史的甲状腺结节呈正预测。 ICM后三个月，34名患者（4.2％）仍然显示甲状腺功能亢进（22来自HB，13名用甲基唑处理）。在ICM之后一年，甲状腺功能亢进症仍然存在于20名患者（2.5％，来自HB，13名治疗）。结论自发性亚临床甲状腺功能亢进症在IHD中的患病率令人惊讶地升高，并且通过碘载荷进一步增加，特别是在甲状腺结节患者和甲状腺疾病的家族性史中，即使在一年后仍然存在不可忽略的数量。

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