open access

Vol 66, No 6 (2015)
Original papers
Published online: 2015-12-07
Submitted: 2015-05-25
Accepted: 2015-08-10
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Thyroid-stimulating hormone concentration as an independent risk factor of venous thromboembolism regardless of thyroid function

Magdaléna Kovářová, Tomáš Koller, Viera Štvrtinová, Juraj Payer
DOI: 10.5603/EP.2015.0058
·
Endokrynologia Polska 2015;66(6):474-479.

open access

Vol 66, No 6 (2015)
Original papers
Published online: 2015-12-07
Submitted: 2015-05-25
Accepted: 2015-08-10

Abstract

Introduction: Thyroid dysfunction has been recognised as playing a role in the coagulation cascade, but the clinical implications of this phenomenon are unclear. The aim of our study was to assess the predictive power of TSH measurement on the presence or absence of venous thromboembolism (VTE).

Material and methods: From January 2009 to August 2012, all consecutive patients hospitalised for suspected VTE were included in the study. VTE was confirmed either by pulmonary angiography or compressive ultrasound. We investigated the predictive power of TSH concentration on the risk of VTE in univariate and multivariate analysis including the existing risk factors (age, D-dimer).

Results: A total of 232 patients were eligible for final analysis, with a median age of 70 years (IQR 58–80) and male-to-female ratio of 124:108. VTE was confirmed in 124 patients (53.4%). TSH concentration was significantly higher in cases with VTE (median 2.17 vs. 1.76 mIU/L, p = 0.0104), but free T4 concentrations were not found to be significantly different. Receiver operating curve analysis identified the cut-off of TSH > 2.686 mIU/L as a predictor of VTE with the prevalence of VTE 47.1 vs. 66.7% below and above this cut-off, p = 0.011. Multivariate logistic regression identified five independent predictors of VTE: male gender (odds ratio, OR = 2.22), D-dimer > 0.5 mg/L OR = 16.42), CRP > 5 g/L (OR = 9.178), TSH > 2.686 mIU/L (OR = 2.269), and age (OR = 0.9767/year).

Conclusions: Among patients with suspected venous thromboembolism TSH concentration was found to be an independent predictor of VTE in addition to gender, D-dimer, C-reactive protein (CRP), and age. (Endokrynol Pol 2015; 66 (6): 474–479)

Abstract

Introduction: Thyroid dysfunction has been recognised as playing a role in the coagulation cascade, but the clinical implications of this phenomenon are unclear. The aim of our study was to assess the predictive power of TSH measurement on the presence or absence of venous thromboembolism (VTE).

Material and methods: From January 2009 to August 2012, all consecutive patients hospitalised for suspected VTE were included in the study. VTE was confirmed either by pulmonary angiography or compressive ultrasound. We investigated the predictive power of TSH concentration on the risk of VTE in univariate and multivariate analysis including the existing risk factors (age, D-dimer).

Results: A total of 232 patients were eligible for final analysis, with a median age of 70 years (IQR 58–80) and male-to-female ratio of 124:108. VTE was confirmed in 124 patients (53.4%). TSH concentration was significantly higher in cases with VTE (median 2.17 vs. 1.76 mIU/L, p = 0.0104), but free T4 concentrations were not found to be significantly different. Receiver operating curve analysis identified the cut-off of TSH > 2.686 mIU/L as a predictor of VTE with the prevalence of VTE 47.1 vs. 66.7% below and above this cut-off, p = 0.011. Multivariate logistic regression identified five independent predictors of VTE: male gender (odds ratio, OR = 2.22), D-dimer > 0.5 mg/L OR = 16.42), CRP > 5 g/L (OR = 9.178), TSH > 2.686 mIU/L (OR = 2.269), and age (OR = 0.9767/year).

Conclusions: Among patients with suspected venous thromboembolism TSH concentration was found to be an independent predictor of VTE in addition to gender, D-dimer, C-reactive protein (CRP), and age. (Endokrynol Pol 2015; 66 (6): 474–479)

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Keywords

venous thromboembolism; thyrotropin; free thyroxine

About this article
Title

Thyroid-stimulating hormone concentration as an independent risk factor of venous thromboembolism regardless of thyroid function

Journal

Endokrynologia Polska

Issue

Vol 66, No 6 (2015)

Pages

474-479

Published online

2015-12-07

DOI

10.5603/EP.2015.0058

Bibliographic record

Endokrynologia Polska 2015;66(6):474-479.

Keywords

venous thromboembolism
thyrotropin
free thyroxine

Authors

Magdaléna Kovářová
Tomáš Koller
Viera Štvrtinová
Juraj Payer

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