Sudeb Mukherjee

Prevalence of Subclinical Hypothyroidism in Acute Coronary Syndrome in Nondiabetics: Detailed Analysis from Consecutive 1100 Patients from Eastern India

Background The association between subclinical thyroid dysfunction (defined by no symptoms or clinical features of hypothyroidism but biochemically TSH level in the range of above 5 miu/ml but below 10 miu/ml with normal FT4 level) and Acute Coronary Syndrome (ACS) is not known so far. This study was done to calculate the prevalence of subclinical thyroid dysfunction in patients with ACS. Methods A retrospective chart review of 1100 consecutive patients was done who presented to Emergency Department with symptoms suggestive of ACS and admitted. They were later classified in 3 categories that includes Acute ST Elevated Myocardial Infarction (STEMI), Unstable Angina (UA), and Acute Non-ST Elevated Myocardial Infarction (NSTEMI). Thyroid function test (FT4, TSH) and antithyroid peroxidase (TPO) were done and evaluated properly. Results Of 1100 consecutive patients 168 (15.27%) patients had the biochemical features of subclinical thyroid dysfunction. These 168 patients include 60 STEMI, 66 NSTEMI, and 42 Unstable Angina patients. There were no statistically significant differences in terms of left ventricular ejection fraction (LVEF) and catheterisation results considering thyroid dysfunction. Conclusions Subclinical thyroid dysfunction is quite prevalent in ACS patients. There are no significant associations between STEMI, Unstable Angina, or NSTEMI patients in terms of thyroid dysfunction neither in single vessel versus multivessel disease involvement. The causative role and outcomes of treatment are still uncertain and need further follow-up.

Biochemical Markers of Cardiac Risk and Their Relation to Spirometric Indices of Airway Obstruction Among COPD Patients

Monitoring of the cardiac status of COPD (Chronic Obstructive Pulmonary Disease) and comparing them with their respiratory indices thought to be predictive markers of the general health of these patients and be indicative, even prognostic, of any impending deterioration. This study was destined to evaluate various aspect of serum prognostic factors in COPD patients. This study was conducted over a period of six months. During this time biochemical markers of 43 (34 male and 9 female) patients suffering from COPD were collected and compared them with those of 40 healthy case control subjects. The Methodology and Exclusion Criteria were strictly adhered to, and based on the statistical analysis shown below the final results were arrived at, which have been discussed at length below. The relation between smoking and COPD found to be controversial, but smoking none the less has a detrimental effect on the respiratory indices and thus, cessation of smoking would definitely benefit these patients, although the extent of the benefit is a matter of debate and further study. As for the individual markers, serum CRP and plasma homocysteine are definitely important as prognostic markers, as well as the indicators of the present stage of the disease. Serum Lipoprotein (a) was not found to be very effective indicator in this study. Homocysteine as well as CRP but not lipoprotein (a), as cardiac indices is inversely related to the respiratory indices of a COPD patient. Measurement of these parameter might help in prognostic evaluation in those patients.