Document Detail

Subclinical hypothyroidism might increase the risk of transient atrial fibrillation after coronary artery bypass grafting.
MedLine Citation:
PMID:  19463607     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Some studies have proposed that subclinical hypothyroidism (SCH) has adverse effects on the cardiovascular system, but little is known about the effect on patients undergoing cardiovascular operations. We examined the influence of preoperative SCH on postoperative outcome in patients undergoing coronary artery bypass grafting (CABG). METHODS: Among patients who underwent CABG between July 2005 and June 2007 at Seoul National University Bundang Hospital, 224 with normal thyroid function and 36 with SCH were enrolled. Preoperative risks and postoperative outcomes were evaluated prospectively without thyroid hormone replacement. RESULTS: There were no significant differences in primary outcomes (major adverse cardiovascular events) and secondary outcomes such as wound problems, mediastinitis, leg infection, respiratory complications, delirium, or reoperation during the same hospitalization. However, patients with SCH had a higher incidence of postoperative atrial fibrillation than those with normal thyroid function after adjustment for age, gender, body mass index, and other independent variables such as emergency operation, the use of cardiopulmonary bypass, combined valvular operation, preoperative creatinine levels, left ventricular systolic dysfunction, and nonuse of beta-blockers (45.5% vs 29%; odds ratio, 2.552; 95% confidence interval, 1.117 to 5.830; p = 0.026). CONCLUSIONS: SCH appears to influence the postoperative outcome for patients by increasing the development of postoperative atrial fibrillation. However, it is still unproven whether preoperative thyroxine replacement therapy for patients with SCH might prevent postoperative atrial fibrillation after CABG.
Young Joo Park; Ji Won Yoon; Kwang Il Kim; You Jin Lee; Kyung Won Kim; Sung Hee Choi; Soo Lim; Dong Ju Choi; Kay-Hyun Park; Joong Haeng Choh; Hak Chul Jang; Seong Yeon Kim; Bo Youn Cho; Cheong Lim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  87     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-06-05     Revised Date:  2010-03-03    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1846-52     Citation Subset:  AIM; IM    
Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Korea.
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MeSH Terms
Atrial Fibrillation / epidemiology*,  etiology*
Coronary Artery Bypass / adverse effects*
Hypothyroidism / complications*,  diagnosis
Preoperative Care
Risk Factors
Comment In:
Ann Thorac Surg. 2010 Mar;89(3):1010-1; author reply 1011-2   [PMID:  20172189 ]

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