Context: Patients with radically treated differentiated thyroid carcinoma (DTC) undergo multiple episodes of iatrogenously-acquired hypothyroidism for the oncological follow-up. In some patients, this elevates high-sensitive C-reactive protein (hsCRP), a cardiovascular risk biomarker.
Objective: We wanted to determine if there is any correlation between repeated hypothyroidism episodes, elevated hsCRP and an increased cardiovascular risk as stated through myocardial perfusion.
Design: Between July 2014-January 2015, we analyzed serological levels of hsCRP for identifying our patients' cardiovascular risk; we performed a myocardial perfusion scintigraphy to observe the alterations.
Subjects and methods: We included 27 patients (n=27), mean age of 52±10: CI (95%),14 female, all disease- free after thyroidectomy, radioiodine ablation and chronic thyroid hormone treatment. We assigned the cardiovascular risk category for each patient according to hsCRP levels; all patients underwent a myocardial perfusion scintigraphy in order to determine the cardiac perfusion index (CPI).
Results: hsCRP has been higher in > 65 years old male patients with more than 5 thyroid hormone withholdings. hsCRP is significantly associated with CPI (p=0.001). Spearman's rank correlation indicates a strongly positive linear correlation between these two parameters (r=0.745).
Conclusions: Repeated thyroid hormonal withdrawals in patients with DTC during the long-term follow-up elevated hsCRP at cardiovascular risk levels, having an impact on myocardial perfusion.
Keywords: cardiovascular risk; differentiated thyroid carcinoma; hsCRP; myocardial perfusion; thyroid hormone withdrawal.