ABC | Volume 110, Nº2, February 2018

Original Article Soeiro et al TSH versus SCA Arq Bras Cardiol. 2018; 110(2):113-118 Analytical methods The following datawere obtained: age, sex, diabetes, systemic arterial hypertension, smoking habit, dyslipidemia, family history of premature coronary artery disease, heart failure, previous coronary artery disease, previous stroke, hematocrit, creatinine, higher troponin, systolic blood pressure, left ventricular ejection fraction andmedications used (within the first 24 hours) (Table 1). Blood was sampled immediately after admission, prior to administration of medications (baseline) and daily, according to institution protocol. TSH was obtained routinely in all patients with ACS. Cardiac markers such as troponin-I were measured using standard clinical chemistry. Laboratory upper limits of normal were 0.04 ng/mL (99 th percentile) for troponin-I measured by Elecsys 2010 ( Siemens Healthcare Diagnostics Inc., USA) 4 th generation immunoassay. Major bleeding was defined using BARC 6 score types 3 and 5, and minor bleedings, types 1 and 2. Post-operative bleeding events were not considered. Statistical analysis Descriptive analyses of data collected included median, minimum and maximum values. Categorical variables were described as percentages. Comparisons between groups were made by ANOVA one-way and chi-square test (to categorical variables), and a p value < 0.05 was considered significant. If Kolmogorov-Smirnov tests confirmed a normal distribution, continuous variables were presented as mean ± standard deviation, and were compared using Student t test for independent samples. Mann-Whitney U test was used to compare not normally distributed continuous variables, which were presented as median and interquartile range. Multivariate analysis was determined by logistic regression, and a p value < 0.05 was considered significant. The patients’ baseline characteristics are shown in Table 1. All statistical procedures were performed using the statistical software SPSS, version 10.0. Results The median age was 63 years, and approximately 59% of patients were male. Baseline characteristics and univariate analysis are shown in Table 1. ST-elevation myocardial infarction (STEMI) was observed in 18% of group I versus 24% of group II (p = 0.08) (Figure 1). Multivariate analysis is shown in Table 2 and describes the differences between groups I and II in combined events Table 1 – Baseline characteristics of patients according with TSH levels. TSH ≤ 4 mIU/L TSH > 4 mIU/L p Age (mean) 62.5 66.3 0.86 * Male (%) 61% 51% 0.14 # Diabetes Mellitus (%) 39% 48% 0.38 # Hypertension (%) 80% 76% 0.49 # Smoking habit (%) 40% 37% 0.72 # FH of CAD (%) 13% 10% 0.56 # Dyslipidemia (%) 47% 48% 0.9 # Heart failure (%) 8% 10% 0.62 # Previous stroke (%) 6% 15% 0.007 # Previous AMI (%) 38% 48% 0.14 # Previous CABG (%) 18% 27% 0.08 # Previous PCI (%) 25% 32% 0.21 # Ht (%) (mean) 42.2 41.5 0.08 * Cr (mg/dL) (mean) 2.18 2.99 0.51 * SBP (mm Hg) (median) 134.5 133.8 0.24 π EF (%) (median) 42.5 33.7 0.62 π Troponin (higher) (ng/dL) (mean) 4.68 7.37 0.52 * ASA (%) 99% 93% 0.12 # Beta-blocker (%) 68% 54% 0.12 # Enoxaparin (%) 72% 58% 0.021 # ACE inhibitor (%) 51% 48% 0.64 # Statin (%) 83% 71% < 0.001 # TSH: thyrotropin; FH: family history; CAD: coronary artery disease; AMI: acute myocardial infarction; CABG: coronary artery bypass grafting; PCI: percutaneous coronary intervention; SBP: systolic blood pressure; Ht: hematocrit; Cr: creatinine; EF: ejection fraction; ASA: acetylsalicylic acid; ACE: angiotensin-converting- enzyme; # :Q-square test; *: Student t test for independent samples; π = Mann-Whitney U test. 114