Thyroid Functions Are Associated with All-Cause Long-Term Mortality in Elderly Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

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OBJECTIVE
Our aim in this study is to show the relationship between long-term all-cause mortality and thyroid functions in the elderly patient group that underwent primary PCI with the diagnosis of STEMI.

METHODS
270 patients over 65 years of age that underwent primary PCI with the diagnosis of STEMI were analyzed retrospectively. After applying exclusion criteria, 198 patients were included in the study. The patients were divided into 2 groups according to their out-of-hospital mortality status. Angiographic, laboratory, echocardiographic and electrocardiographic data were analyzed.


RESULTS
The mean age of 198 patients in the study was 72.5±6.6, and the median follow-up time was 101.7 months. Age was higher in the mortality group (70.4±5.4 vs. 74.5±6.9, p<0.001). In multivariate analysis, age (OR: 1.59, p: 0.003), insülin (OR: 2.561, p: 0.016), angina-balloon time (OR: 1.134, p: 0.002), number of serious stenoses (OR: 1.702, p: 0.003), creatine (OR: 3.043, p<0.001), fT4 (OR: 2.026, p: 0.026) were determined as independent predictors of mortality. FT4 level was correlated with uric acid level (R: 0.182, p: 0.02), and fT3 was correlated with albumin (R: -0.253, p: 0.001) and creatine (R: -0.224, p: 0.003) levels in the correlation analysis. FT4 level cut-off value of 0.99 had sensitivity of 76%, specificity of 54%, and an area under the curve of 0.675 in predicting mortality. In Kaplan-Maier analysis, it was found that fT4 elevation was strongly associated with mortality (p: 0.01).


CONCLUSIONS
In our study, subclinical values in thyroid functions were found to be associated with increased mortality, apart from known factors in elderly patients who underwent primary PTCA with the diagnosis of STEMI."