Background: The role of euthyroid hormone levels in clinical outcomes after drug-coated balloon (DCB) angioplasty in patients with coronary heart disease (CHD) remains unclear. Thus, this study aimed to explore the relationship between thyroid function and the risk of restenosis at one year, as well as the prognosis over five years in euthyroid patients with CHD following DCB angioplasty. Methods: This prospective study evaluated 189 euthyroid CHD patients who underwent successful DCB angioplasty. Coronary angiographic follow-up was performed 9–12 months post-procedure to assess the status of target lesions, with restenosis defined as ≥50% reduction in luminal diameter. All patients underwent five-year clinical follow-ups, during which major adverse cardiovascular events (MACEs) were recorded. Results: Following angiographic follow-ups, patients were categorized into two groups: those with restenosis (n = 66) and those without (n = 123). At baseline and during the follow-up, the restenosis group demonstrated significantly higher levels of thyroid-stimulating hormone (TSH), lymphocytes, hemoglobin A1c (HbA1c), lipoprotein(a), and platelet count, along with lower free triiodothyronine (FT3) levels. Multivariable logistic regression analysis revealed that the TSH levels both at the baseline (odds ratio (OR) 1.607, 95% confidence interval (CI) 1.238–2.085, p < 0.001) and angiographic follow-up (OR 2.970, 95% CI 2.000–4.411, p < 0.001) were independently associated with an increased risk of post-DCB restenosis. Furthermore, patients in the high TSH tertile had a 90% increased risk of MACEs during the 5-year follow-up period (hazard ratio (HR) 1.922, 95% CI 1.343–2.750, p < 0.001) compared with those in the low TSH tertile. Conclusions: A high-normal TSH level within the euthyroid range was strongly associated with an increased 1-year restenosis risk and decreased 5-year MACE-free survival following DCB angioplasty in CHD patients.
Duan et al. (Wed,) studied this question.