M Saftencu1, E Barbus1,2, C Pestean1,2, A Piciu1,2, D Piciu1,2. 1. Piciu"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. 2. "Prof.Dr.Ion Chiricuta" Institute of Oncology, Dept. of Nuclear Medicine, Cluj-Napoca, Romania.
Abstract
CONTEXT: Patients with radically treated differentiated thyroid carcinoma (DTC) undergo multiple episodes of iatrogenously-acquired hypothyroidism for the oncological follow-up. In some patients, this elevates high-sensitive C-reactive protein (hsCRP), a cardiovascular risk biomarker. OBJECTIVE: We wanted to determine if there is any correlation between repeated hypothyroidism episodes, elevated hsCRP and an increased cardiovascular risk as stated through myocardial perfusion. DESIGN: Between July 2014-January 2015, we analyzed serological levels of hsCRP for identifying our patients' cardiovascular risk; we performed a myocardial perfusion scintigraphy to observe the alterations. SUBJECTS AND METHODS: We included 27 patients (n=27), mean age of 52±10: CI (95%),14 female, all disease- free after thyroidectomy, radioiodine ablation and chronic thyroid hormone treatment. We assigned the cardiovascular risk category for each patient according to hsCRP levels; all patients underwent a myocardial perfusion scintigraphy in order to determine the cardiac perfusion index (CPI). RESULTS: hsCRP has been higher in > 65 years old male patients with more than 5 thyroid hormone withholdings. hsCRP is significantly associated with CPI (p=0.001). Spearman's rank correlation indicates a strongly positive linear correlation between these two parameters (r=0.745). CONCLUSIONS: Repeated thyroid hormonal withdrawals in patients with DTC during the long-term follow-up elevated hsCRP at cardiovascular risk levels, having an impact on myocardial perfusion.
CONTEXT: Patients with radically treated differentiated thyroid carcinoma (DTC) undergo multiple episodes of iatrogenously-acquired hypothyroidism for the oncological follow-up. In some patients, this elevates high-sensitive C-reactive protein (hsCRP), a cardiovascular risk biomarker. OBJECTIVE: We wanted to determine if there is any correlation between repeated hypothyroidism episodes, elevated hsCRP and an increased cardiovascular risk as stated through myocardial perfusion. DESIGN: Between July 2014-January 2015, we analyzed serological levels of hsCRP for identifying our patients' cardiovascular risk; we performed a myocardial perfusion scintigraphy to observe the alterations. SUBJECTS AND METHODS: We included 27 patients (n=27), mean age of 52±10: CI (95%),14 female, all disease- free after thyroidectomy, radioiodine ablation and chronic thyroid hormone treatment. We assigned the cardiovascular risk category for each patient according to hsCRP levels; all patients underwent a myocardial perfusion scintigraphy in order to determine the cardiac perfusion index (CPI). RESULTS: hsCRP has been higher in > 65 years old male patients with more than 5 thyroid hormone withholdings. hsCRP is significantly associated with CPI (p=0.001). Spearman's rank correlation indicates a strongly positive linear correlation between these two parameters (r=0.745). CONCLUSIONS: Repeated thyroid hormonal withdrawals in patients with DTC during the long-term follow-up elevated hsCRP at cardiovascular risk levels, having an impact on myocardial perfusion.
Authors: Thomas A Pearson; George A Mensah; R Wayne Alexander; Jeffrey L Anderson; Richard O Cannon; Michael Criqui; Yazid Y Fadl; Stephen P Fortmann; Yuling Hong; Gary L Myers; Nader Rifai; Sidney C Smith; Kathryn Taubert; Russell P Tracy; Frank Vinicor Journal: Circulation Date: 2003-01-28 Impact factor: 29.690
Authors: H William Strauss; D Douglas Miller; Mark D Wittry; Manuel D Cerqueira; Ernest V Garcia; Abdulmassi S Iskandrian; Heinrich R Schelbert; Frans J Wackers; Helena R Balon; Otto Lang; Josef Machac Journal: J Nucl Med Technol Date: 2008-08-14
Authors: David S Cooper; Gerard M Doherty; Bryan R Haugen; Bryan R Hauger; Richard T Kloos; Stephanie L Lee; Susan J Mandel; Ernest L Mazzaferri; Bryan McIver; Furio Pacini; Martin Schlumberger; Steven I Sherman; David L Steward; R Michael Tuttle Journal: Thyroid Date: 2009-11 Impact factor: 6.568
Authors: M Chianelli; V Todino; F M Graziano; C Panunzi; D Pace; R Guglielmi; A Signore; E Papini Journal: Eur J Endocrinol Date: 2008-12-12 Impact factor: 6.664
Authors: M Luster; S E Clarke; M Dietlein; M Lassmann; P Lind; W J G Oyen; J Tennvall; E Bombardieri Journal: Eur J Nucl Med Mol Imaging Date: 2008-10 Impact factor: 9.236
Authors: R Elisei; M Schlumberger; A Driedger; C Reiners; R T Kloos; S I Sherman; B Haugen; C Corone; E Molinaro; L Grasso; S Leboulleux; I Rachinsky; M Luster; M Lassmann; N L Busaidy; R L Wahl; F Pacini; S Y Cho; J Magner; A Pinchera; P W Ladenson Journal: J Clin Endocrinol Metab Date: 2009-10-22 Impact factor: 5.958