Association of baseline thyroid stimulating hormone with in-hospital outcomes in patients with atrial fibrillation and coronary artery diseases.

Objective: Thyroid-stimulating hormone (TSH) is related to increased atrial fibrillation (AF) inducibility and plays an important role in a variety of cardiovascular diseases. However, the association of baseline TSH with in-hospital outcomes in patients with AF and coronary artery disease (CAD) is unknown. This study aimed to investigate the distribution of baseline TSH and its association with in-hospital outcomes (major adverse cardiovascular events [MACE], all-cause death, or heart failure [HF]) in AF patients combined with CAD.

Methods: A total of 19,725 patients with AF were included. The status of blood TSH was investigated. Patients with AF and CAD were divided into low, median, and high-TSH subgroups based on tertiles of baseline TSH levels. Clinical characteristics and in-hospital outcomes were compared. Logistic regression analysis was performed to determine the association of TSH with in-hospital outcomes. Subgroup analysis was also performed.

Results: In patients with AF and CAD, compared with the low-TSH group, the median-TSH (OR 0.277, 95% CI 0.078-0.991, P = 0.048) and high-TSH (OR 0.163, 95% CI 0.036-0.750, P = 0.020) groups were associated with decreased all-cause death. Besides, high TSH showed a protective role for HF events, and the same results were seen in females, age≥75, and non-non-hypertension subgroups.

Conclusion: Higher baseline TSH presented a protective effect on in-hospital all-cause death and HF in patients with AF combined with CAD.