مقاله انگلیسی رایگان در مورد تیروئید در بیماری قلبی عروقی – الزویر 2018

Thyroid dysfunctions, particularly hypothyroidism, predispose to cardiovascular diseases, such as atherosclerotic coronary artery disease. However, thyroid functions are not always assessed in such patients. In this report, we studied the cases with pathologically evident ischemic heart disease (IHD) at autopsy and correlated with absence or presence of thyroid disease. In a five-year retrospective autopsy-based study, cases with IHD in whom the thyroid gland was dissected at autopsy were analyzed. The thyroid gland was available for assessment in 181 of the 255 autopsied cases with IHD. Majority were males with a mean age of 59.9 years. Thyroid pathology was noted in 58 patients (32.0%) in the form of uni-nodular or multinodular goiter (56.9%), lymphocytic thyroiditis (37.9%) and Hashimoto’s thyroiditis (5.2%). Based on our experience, we feel it may be worthwhile to assess the thyroid by simple inspection and palpation followed by ultrasonographic imaging and estimations of the hormones, thyroid-stimulating hormone and anti-thyroidal antibodies in all patients presenting with IHD.

Introduction

The Indian subcontinent, home to 20% of the world’s population, is estimated to have one of the highest burdens of cardiovascular disease (CVD) in the world and majority of the cases have been attributed to ischemic heart disease (IHD), related mainly to atherosclerotic coronary artery disease (CAD). This has assumed an epidemic proportion in India as a fall-out of rapid urbanization (in the form of increased intake of energy-dense foods, usage of tobacco, a decrease in physical activity and a heightened level of psychosocial stress) as well as a high prevalence of genetically mediated factors (such as elevated levels of Lp (a), homocysteine, fibrinogen, and plasminogen activator inhibitor). These factors sooner or later lead to development of dysglycemia, hypertension, and dyslipidemia, which are the major atherosclerotic risk factors.1 Similarly, diseases of the thyroid (both hypothyroidism and hyperthyroidism), which are also very common worldwide, predispose to CVD in general and CAD in particular.2 This becomes more relevant in patients with hypothyroidism (often associated with dyslipidemia), which is the most common of thyroid disorders in India, affecting one in ten adults.3 However, as a routine, investigations for thyroid functions are not always requested for in a setting of CAD. Furthermore, autopsy studies on the thyroid have also not focused on the relationship between thyroid disease and CAD. In this report, we studied the cases with clinically and/or pathologically evident IHD at autopsy and correlated with absence or presence of thyroid disease.