Cardiology
doi: 10.25005/2074-0581-2022-24-3-306-316
DYSLIPIDEMIA AND SEVERITY OF ATHEROSCLEROTIC CORONARY ARTERY DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROME AND SUBCLINICAL HYPOTHYROIDISM

E.B. Petrova1,2, O.N. Shishko2, T.V. Statkevich2, A.A. Pleshko2, N.P. Mitkovskaya1,2

1Republican Scientific and Practical Center "Cardiology", Minsk, Republic of Belarus
2Belarusian State Medical University, Minsk, Republic of Belarus

Objective: To assess the derangements in lipid metabolism and the severity of atherosclerotic disease of the coronary arteries in patients with the acute coronary syndrome (ACS) and subclinical hypothyroidism (SHT).

Methods: 146 medical records of inpatients of working age with newly developed ACS and various thyroid hormonal statuses were analysed. The lipid profile, high-sensitivity C-reactive protein (hs-CRP), thyroid-stimulating hormone (TSH), and free thyroid hormones (free thyroxine, FT4, and free triiodothyronine, FT3) levels were investigated. Coronary angiography results were used to assess coronary atherosclerotic plaque burden. The study group comprised 67 patients with ACS and SHT (TSH level >4.0 mIU/l with normal thyroid hormone levels), and the control group included 79 ACS patients without thyroid hormonal abnormalities. The groups were matched for the presence of unhealthy habits, gender, age, and severity of arterial hypertension. Before admission to the hospital, patients did not receive preventive therapy for coronary artery disease (CAD) or hormone replacement therapy.

Results: In SHT patients, in comparison with the group of patients with normal thyroid function, the proportion of individuals with type IIa hyperlipidemia was higher – 82.0% (n=55) and 46.8% (n=37), respectively (χ2=19.33; p<0.001). A medium strength direct correlation was established between laboratory confirmed SHT and atherogenic dyslipidemia (r=0.62; p<0.01), an increase in the level of hs-CRP (r=0.74; p<0.01), and multivessel CAD (r=0.58; p<0.05).

Conclusion: In patients with CHT, the proportion of individuals with multivessel coronary artery stenosis is higher, and CAD occurs in the presence of hs-CRP and atherogenic dyslipidemia.

Keywords: Acute coronary syndrome, coronary artery disease, atherosclerosis, hyperlipidemia, subclinical hypothyroidism, thyroid gland.

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Authors' information:

Petrova Ekaterina Borisovna
Candidate of Medical Sciences, Associate Professor, Scientific Secretary of the Republican Scientific and Practical Center "Cardiology"; Associate Professor of the Department of Cardiology and Internal Diseases, Belarusian State Medical University
Researcher ID: C-6682-2018
Scopus ID: 57225846383
SPIN: 6013-9366
Author ID: 836560
E-mail: Katrin.sk-81@tut.by

Shishko Olga Nikolaevna
Candidate of Medical Sciences, Assistant of the Department of Endocrinology, Belarusian State Medical University
Scopus ID: 57194381123
E-mail: shyshko.volha@tut.by

Statkevich Tatyana Vasilevna
Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of Cardiology and Internal Diseases, Belarusian State Medical University
Scopus ID: 57202157211
ORCID ID: 0000-0001-6462-4793
SPIN: 3386-3384
Author ID: 987751
E-mail: forget-me@tut.by

Pleshko Aleksandr Aleksandrovich
Assistant of the Department of Cardiology and Internal Diseases, Belarusian State Medical University
Scopus ID: 57219878700
E-mail: andybo747@gmail.com

Mitkovskaya Natalya Pavlovna
Doctor of Medical Sciences, Full Professor, Director of the Republican Scientific and Practical Center "Cardiology"; Head of the Department of Cardiology and Internal Diseases, Belarusian State Medical University
Researcher ID: AAV-6369-2021
Scopus ID: 6507367973
ORCID ID: 0000-0002-9088-721X
SPIN: 6237-2736
Author ID: 575103
E-mail: mitkovskaya1@mail.ru

Information about support in the form of grants, equipment, medications

The study was conducted within the Research and Development framework under task 02.32 "Develop and implement a method for predicting the development of atherosclerosis in patients with hypo- and hyperthyroidism" of the subprogram "Cardiology and Cardiac Surgery" under the guidelines of the state scientific and technical program "Scientific and technical support of quality and availability of healthcare services", 2021-2025. However, the authors did not receive financial support from drug and medical device manufacturing companies

Conflicts of interest: No conflict

Address for correspondence:

Petrova Ekaterina Borisovna
Candidate of Medical Sciences, Associate Professor, Scientific Secretary of the Republican Scientific and Practical Center "Cardiology"; Associate Professor of the Department of Cardiology and Internal Diseases, Belarusian State Medical University

220036, Republic of Belarus, Minsk, Roza Lyuksemburg str., 110B

Tel.: +375 (447) 088111

E-mail: Katrin.sk-81@tut.by

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