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756166 
Journal Article 
Subclinical hypothyroidism might increase the risk of transient atrial fibrillation after coronary artery bypass grafting 
Park, YJ; Yoon, JW; Kim, KI; Lee, YJ; Kim, KW; Choi, SH; Lim, S; Choi, DJ; Park, KH; Choh, JH; Jang, HC; Kim, SY; Cho, BY; Lim, C 
2009 
Yes 
Annals of Thoracic Surgery
ISSN: 0003-4975
EISSN: 1552-6259 
ELSEVIER SCIENCE INC 
NEW YORK 
87 
6 
1846-1852 
English 
19463607 
WOS:000266234900031 
Some studies have proposed that subclinical hypothyroidism (SCH) has adverse effects on the cardiovascular system, but little is known about the effect on patients undergoing cardiovascular operations. We examined the influence of preoperative SCH on postoperative outcome in patients undergoing coronary artery bypass grafting (CABG).

Among patients who underwent CABG between July 2005 and June 2007 at Seoul National University Bundang Hospital, 224 with normal thyroid function and 36 with SCH were enrolled. Preoperative risks and postoperative outcomes were evaluated prospectively without thyroid hormone replacement.

There were no significant differences in primary outcomes (major adverse cardiovascular events) and secondary outcomes such as wound problems, mediastinitis, leg infection, respiratory complications, delirium, or reoperation during the same hospitalization. However, patients with SCH had a higher incidence of postoperative atrial fibrillation than those with normal thyroid function after adjustment for age, gender, body mass index, and other independent variables such as emergency operation, the use of cardiopulmonary bypass, combined valvular operation, preoperative creatinine levels, left ventricular systolic dysfunction, and nonuse of beta-blockers (45.5% vs 29%; odds ratio, 2.552; 95% confidence interval, 1.117 to 5.830; p = 0.026).

SCH appears to influence the postoperative outcome for patients by increasing the development of postoperative atrial fibrillation. However, it is still unproven whether preoperative thyroxine replacement therapy for patients with SCH might prevent postoperative atrial fibrillation after CABG.