Long-term effect of a large dose of iodinated contrast in patients with mild thyroid dysfunction:a prospective cohort study  

作　　者：Hailong Si Kangyin Chen Qin Qin Yuanyuan Liu Bingrang Zhao 

机构地区：[1]Department of Cardiology,Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease,Tianjin Institute of Cardiology,The Second Hospital of Tianjin Medical University,Tianjin 300211,China [2]Department of Cardiovascular Disease,Tianjin Chest Hospital,Tianjin 300051,China [3]Tianjin Institute of Cardiovascular Diseases,Tianjin Chest Hospital,Tianjin 300051,China [4]Comprehensive Disease Center,Tianjin Chest Hospital,Tianjin 300051,China

出　　处：《Chinese Medical Journal》2023年第17期2044-2049,共6页中华医学杂志（英文版）

基　　金：supported by grants from the Hospital Level Project of Tianjin Chest Hospital in 2018(No.2018XKC08);funded by the Tianjin Key Medical Discipline(Specialty)Construction Project.

摘　　要：Background:More than 75 million procedures with intravascular iodine-based contrast media(ICM)are performed worldwide every year,and some patients undergoing these procedures do not have normal thyroid function.The long-term effects of ICM in patients with mild thyroid dysfunction(TD)are unclear.Methods:This prospective cohort study was conducted in China.Patients with stable angina pectoris with total triiodothyronine(TT3)reduction,normal thyroid-stimulating hormone,and reverse triiodothyronine(rT3)were enrolled and divided into high-dose(≥100 mL ICM)and low-dose groups(<100 mL ICM).We dynamically investigated the trends in thyroid function,rT3,and thyroid antibodies one year after ICM exposure.Results:A total of 154 patients completed 6 months of follow-up and 149 completed 1 year of follow-up.Thyroglobulin antibody(TGAB)levels were elevated in 41(26.6%)patients before ICM exposure,11(7.1%)of whom also had elevated thyroid peroxidase antibody levels.Transient subclinical TD occurred 6 months after ICM exposure;75.5%(34/45)of post-operative TD occurred in the high-dose group.One patient developed severe hypothyroidism with myxedema,requiring drug intervention 1 year after ICM exposure.The level of rT3 showed no statistically significant changes during post-operative follow-up(P=0.848).The TGAB level decreased at 6th month(P<0.001),but increased at 1 year after ICM exposure(P=0.002).Conclusions:Patients with T3 reduction are at a risk of transient subclinical TD and hypothyroidism after a single large dose of ICM.Follow-up of this population at 9-12 months after ICM exposure is warranted.

关 键 词：Coronary heart disease Stable angina pectoris Iodinated contrast agents Low T3 Subclinical thyroid dysfunction Non-thyroidal illness 

分 类 号：R581[医药卫生—内分泌]