Thyroid hormone patterns in elderly patients undergoing elective coronary procedures

Background and Objectives: Thyroid dysfunction is common in the elderly. We sought to explore thyroid hormone patterns in a series of elderly patients undergoing elective coronary procedures and their relation to the extent of coronary artery disease. Materials and Methods: We enrolled 81 consecutive elderly patients admitted to undergo elective diagnostic or interventional coronary procedures. Samples were collected for assay of free thyroxin, free tri-iodothyronine, thyroid stimulating hormone, anti-thyroglobulin and anti-thyroid peroxidase antibodies. According to the number of coronary arteries affected by significant stenosis (≥70% luminal obstruction), we classified patients into a group with insignificant coronary disease, another with single vessel disease, and a third group with multi-vessel disease. Results: Forty one (50.6%) patients were euthyroid, two patients (2.5%) had subclinical hypothyroidism, and 12 (14.8%) had clinical hypothyroidism. Yet, neither subclinical nor clinical hypothyroidism was statistically different among the 3 groups, (p >0.05 for both). Additionally, 3 patients (3.7%) had subclinical, and 2 (2.5%) had clinical hyperthyroidism. Finally, 21 patients (25.9%) had sick euthyroid syndrome. Again, all were statistically similar between the study groups, (p >0.5 for all). Similarly, both anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies were statistically similar among the 3 groups (p >0.05 for both). Conclusion: Thyroid hormone disturbances are quite frequent in elderly patients undergoing elective coronary procedures, chiefly in the form of a hypothyroid state. These data do not support that thyroid hormone patterns relate to the extent of coronary artery disease in the elderly.