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Advisor(s)
Abstract(s)
Introdução: O hipotiroidismo subclínico caracteriza-se por um estado clínico assintomático em que se verificam níveis séricos de tireotropina, ou hormona estimuladora da tiróide, elevados, na presença de níveis normais de tiroxina. Ainda existe controvérsia acerca do hipotiroidismo subclínico predispor a ocorrência de aterosclerose coronária e enfarte agudo do miocárdio, apesar de vários estudos terem demonstrado uma prevalência significativa de hipotiroidismo subclínico nesses casos. O objetivo deste estudo foi analisar a evidência para uma possível relação entre hipotiroidismo subclínico e enfarte agudo do miocárdio.
Métodos: Foi realizada uma pesquisa na base de dados PUBMED visando a procura de artigos de estudos epidemiológicos, artigos de investigação e meta-análises, restritos à língua inglesa, espanhola ou portuguesa, sobre o tema em estudo.
Resultados: Foram identificados 17 estudos originais e 3 meta-análises, envolvendo um total de 65338 participantes. A maioria dos estudos analisados sugere uma relação entre o hipotiroidismo subclínico, aterosclerose coronária e enfarte do miocárdio, apesar de muitas vezes essa associação não se mostrar muito forte. Uma minoria apresenta uma correlação negativa entre hipotiroidismo subclínico e mortalidade.
Discussão/Conclusão: Concluiu-se, após a análise sistemática, que a maioria dos estudos evidenciou um risco moderado de enfarte agudo do miocárdio nos indivíduos com hipotiroidismo subclínico. Esse risco poderá ser provocado pelos mesmos mecanismos que o hipotiroidismo clínico. No entanto, será necessária a realização de ensaios sobre o tratamento desta condição, para avaliar o custo-benefício e determinar se o rastreio é eficaz e necessário.
Introduction: Subclinical hypothyroidism is characterized by an asymptomatic clinical state in which there are high levels of serum thyrotropin, or thyroid stimulating hormone, in the presence of normal levels of thyroxine. There is still controversy about subclinical hypothyroidism predisposing to the occurrence of coronary atherosclerosis and acute myocardial infarction, although several studies have demonstrated a significant prevalence of subclinical hypothyroidism in these cases. The aim of this study was to analyse the evidence for a possible relationship between subclinical hypothyroidism and acute myocardial infarction. Methodology: A search was conducted in PUBMED database to find articles of epidemiological studies, research articles and meta-analyzis, restricted to English, Spanish or Portuguese language, about the subject in question. Results: A total of 17 original studies and 3 meta-analyzes were identified, involving a total of 65338 individuals. Most of the articles analyzed stated a relationship between subclinical hypothyroidism, coronary atherosclerosis and myocardial infarction, although often this association did not prove to be very strong. A minority of them showed a negative correlation between subclinical hypothyroidism and mortality. Discussion/Conclusion: It was concluded, after the analysis, that most studies showed a moderate risk of acute myocardial infarction in individuals with subclinical hypothyroidism. This risk would be assigned to the same mechanisms of overt hypothyroidism. However, more trials on the treatment of this condition are needed, to assess the cost-benefit so that in the future we may know whether screening is effective and necessary.
Introduction: Subclinical hypothyroidism is characterized by an asymptomatic clinical state in which there are high levels of serum thyrotropin, or thyroid stimulating hormone, in the presence of normal levels of thyroxine. There is still controversy about subclinical hypothyroidism predisposing to the occurrence of coronary atherosclerosis and acute myocardial infarction, although several studies have demonstrated a significant prevalence of subclinical hypothyroidism in these cases. The aim of this study was to analyse the evidence for a possible relationship between subclinical hypothyroidism and acute myocardial infarction. Methodology: A search was conducted in PUBMED database to find articles of epidemiological studies, research articles and meta-analyzis, restricted to English, Spanish or Portuguese language, about the subject in question. Results: A total of 17 original studies and 3 meta-analyzes were identified, involving a total of 65338 individuals. Most of the articles analyzed stated a relationship between subclinical hypothyroidism, coronary atherosclerosis and myocardial infarction, although often this association did not prove to be very strong. A minority of them showed a negative correlation between subclinical hypothyroidism and mortality. Discussion/Conclusion: It was concluded, after the analysis, that most studies showed a moderate risk of acute myocardial infarction in individuals with subclinical hypothyroidism. This risk would be assigned to the same mechanisms of overt hypothyroidism. However, more trials on the treatment of this condition are needed, to assess the cost-benefit so that in the future we may know whether screening is effective and necessary.
Description
Keywords
Aterosclerose Coronária Doença Coronária Enfarte Agudo do Miocárdio Fator de Risco Cardiovascular Hipotiroidismo Subclínico Mortalidade Cardiovascular Tiroide