Thyroid Antibody Status, Subclinical Hypothyroidism, and the Risk of Coronary Heart Disease: An Individual Participant Data Analysis
Year: 2014
Type: review
Abstract: CONTEXT: Subclinical hypothyroidism has been associated with increased risk of coronary heart disease (CHD), particularly with thyrotropin levels of 10.0 mIU/L or greater. The measurement of thyroid antibodies helps predict the progression to overt hypothyroidism, but it is unclear whether thyroid autoimmunity independently affects CHD risk. OBJECTIVE: The objective of the study was to compare the CHD risk of subclinical hypothyroidism with and without thyroid peroxidase antibodies (TPOAbs). DATA SOURCES AND STUDY SELECTION: A MEDLINE and EMBASE search from 1950 to 2011 was conducted for prospective cohorts, reporting baseline thyroid function, antibodies, and CHD outcomes. DATA EXTRACTION: Individual data of 38 274 participants from six cohorts for CHD mortality followed up for 460 333 person-years and 33 394 participants from four cohorts for CHD events. DATA SYNTHESIS: Among 38 274 adults (median age 55 y, 63% women), 1691 (4.4%) had subclinical hypothyroidism, of whom 775 (45.8%) had positive TPOAbs. During follow-up, 1436 participants died of CHD and 3285 had CHD events. Compared with euthyroid individuals, age- and gender-adjusted risks of CHD mortality in subclinical hypothyroidism were similar among individuals with and without TPOAbs [hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.87-1.53 vs HR 1.26, CI 1.01-1.58, P for interaction = .62], as were risks of CHD events (HR 1.16, CI 0.87-1.56 vs HR 1.26, CI 1.02-1.56, P for interaction = .65). Risks of CHD mortality and events increased with higher thyrotropin, but within each stratum, risks did not differ by TPOAb status. CONCLUSIONS: CHD risk associated with subclinical hypothyroidism did not differ by TPOAb status, suggesting that biomarkers of thyroid autoimmunity do not add independent prognostic information for CHD outcomes.
DOI: 10.1210/jc.2014-1250
Authors: Tinh-Hai Collet, Douglas C. Bauer, Anne R. Cappola, Bjørn O. Åsvold, Stefan Weiler, Eric Vittinghoff, Jacobijn Gussekloo, Alexandra Bremner, Wendy P. J. den Elzen, Rui M. B. Maciel, Mark P. J. Vanderpump, Jacques Cornuz, Marcus Dörr, Henri Wallaschofski, Anne B. Newman, José A. Sgarbi, Salman Razvi, Henry Völzke, John P. Walsh, Drahomir Aujesky, Nicolas Rodondi
Institutions: Centre Hospitalier Universitaire Vaudois, University of Lausanne, University of California, San Francisco, University of Pennsylvania, Norwegian University of Science and Technology, St Olav's University Hospital, University of Bern, University Hospital of Bern, University Hospital Zurich, Leiden University Medical Center, The University of Western Australia, Universidade Federal de São Paulo, The Royal Free Hospital, Universitätsmedizin Greifswald, German Centre for Cardiovascular Research, Universität Greifswald, University of Pittsburgh, Faculdade de Medicina de Marília, National Health Service, Gateshead Health NHS Foundation Trust, Sir Charles Gairdner Hospital
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, National Institutes of Health, University of California, San Francisco, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Arthritis and Musculoskeletal and Skin Diseases
Awards: G109016790, G1177103769, G1220223050, CHS-ULTRASOUND READING, CORONARY HEART DISEASE AND STROKE, MRI READING CENTER FOR THE CARDIOVASCULAR HEALTH STUDY, G2194386449, G247538147, Exceptional Survival: Trajectories to Functional Aging (CHS All Stars), G277826483, G2800149121, Subclinical thyroid dysfunction in the elderly, G328935669, Novel biomarkers and skeletal outcomes associated with subclinical thyroid dysfunction: a prospective evaluation and impact of treatment, CENTRAL BLOOD ANALYSIS LABORATORY FOR CHS, Predictors of Alheimers Disease in Mild Cognitive Impairment, G4048755144, G4123730617, G423252844, G4454824495, Subcortical Hyperintensities in Sleep Apnea Syndrome, Cardiovascular and neuropsychiatric outcomes associated with subclinical thyroid dysfunction: a prospective evaluation, G4841521052, CHS Events Follow-up Study, G61834786, G6226795708, CHS-Transition Phase, CHS RETINAL READING CENTER, CARDIOVASCULAR HEALTH STUDY--ECHOCARDIOGRAPHY, G7999488110, Biomarker Research in Musculoskeleton Disease, COGNITIVE TESTS, APOE, BRAIN MRI AND RISKS OF DEMENTIA, G8593276544, G880118091, G8866174343, Pittsburgh Older Americans Independence Center, G905887895
OpenAlex ID: W2095948051