Thyroid hypofunction as a predictor of the absence of clinically significant coronary stenosis in elderly patients with coronary heart disease and typical stable angina

Abstract The aim of the work was to determine predictors of the absence of hemodynamically significant coronary stenosis (HCS) in elderly patients with coronary heart disease (CHD) and typical stable angina. We compared the results of coronary angiography performed in Tyumen Cardiological Centre in 1998-2010 in CHD patients presenting with typical stable angina with and without HSC at the age of above and below 65 yr (n = 100 and 958 respectively). Women comprised 61.0 and 44.5% of the elderly and younger patients respectively, with 18.8 and 33.4% having inherited risk of CHD (p < 0.001). Angina of effort (I-III FC) was documented in 87.9% of the elderly patients compared with 77.6% among the younger ones (p = 0.018), FC III circulatory insufficiency (NYHA) in 24.0 vs 10.0% (p < 0.001), compensated thyroid hypofunction in 41.6 vs 28.0% (p = 0.010), history of myocardial infarction in 15.0 vs 25.9% (p = 0.016). Results of echocardiography suggest higher indices of linear heart dimension including those of aortic root and left auricle (19.2 +/- -2.5 vs 17. +/- -2.2 mm and 2. +/- -2.7 vs 21. +/- -2.4 mm; p < 0.001). Elderly patients more frequently showed echocardiographic signs of atheroscleotic lesions of aorta (92.8 vs 60.6%; p < 0.001) and valvular pathology including aortic stenosis (9.2 vs 2.9%; p= 0.001). The study revealed the independent relationship of aortic stenosis, thyroid hypofunction, echocardiac signs of aortic atherosclerosis, enlarged left auricle and aortic root, and previous myocardial infarction with the age of patients with CHD and typical stable angina without HCS.