OUTCOME OF PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY IN PATIENTSWITH SUBCLINICAL HYPOTHYROIDISM

To determine the outcomes of percutaneous transluminal angioplasty (PT CA) in patients with subclinical hypothyroidism and to compare them wi th those in euthyroid patients, we studied retrospectively 48 hypothyr oid (4 overtly and 44 subclinically hypothyroid) and 122 euthyroid pat ients who had a PTCA in Boston's Beth Israel Hospital between 1984 and 1994. No significant differences were detected in bradycardia (relati ve risk, RR: 0.96), tachyarrhythmia (RR: 0.62), heart failure (RR: 2.2 7), hypotension (RR: 1.95), or bleeding (RR: 2.48) in the immediate po stprocedure period between euthyroid and subclinically hypothyroid pat ients. There was a trend towards an increased incidence of chest pain (43.2 vs 27.5%, RR: 1.57, p = 0.084), dissection (50 vs 33%, RR: 1.51, p = 0.06) as an immediate, and reocclusion as an early (within 2 week s) postprocedure complication (6.25 vs .9%, RR: 6.81, p = 0.08). Howev er, chest pain accompanied by electrocardiographic changes was not sig nificantly different between the two groups (20.5 vs 14.7%, RR: 1.4, p = 0.47). There was no difference in the number of procedures rated as successful (subclinically hypothyroid vs euthyroid: 90.2 vs 92.7%). H ospital charges, discharge destination, interval to next admission to the hospital, and in-hospital mortality were not different between the two groups. Subclinical hypothyroidism does not appear to be a risk f actor for significant morbidity or increased mortality following PTCA. Prospective long-term studies with increased statistical power are ne eded to clarify whether there is an association between hypothyroidism and complications (especially chest pain, dissection, and/or reocclus sion) in the early (2 weeks) and late (6 months) post-PTCA period.