Year: 2012
Type: article
Abstract: BACKGROUND: Data from prospective cohort studies regarding the association between subclinical hyperthyroidism and cardiovascular outcomes are conflicting.We aimed to assess the risks of total and coronary heart disease (CHD) mortality, CHD events, and atrial fibrillation (AF) associated with endogenous subclinical hyperthyroidism among all available large prospective cohorts. METHODS: Individual data on 52 674 participants were pooled from 10 cohorts. Coronary heart disease events were analyzed in 22 437 participants from 6 cohorts with available data, and incident AF was analyzed in 8711 participants from 5 cohorts. Euthyroidism was defined as thyrotropin level between 0.45 and 4.49 mIU/L and endogenous subclinical hyperthyroidism as thyrotropin level lower than 0.45 mIU/L with normal free thyroxine levels, after excluding those receiving thyroid-altering medications. RESULTS: Of 52 674 participants, 2188 (4.2%) had subclinical hyperthyroidism. During follow-up, 8527 participants died (including 1896 from CHD), 3653 of 22 437 had CHD events, and 785 of 8711 developed AF. In age- and sex-adjusted analyses, subclinical hyperthyroidism was associated with increased total mortality (hazard ratio[HR], 1.24, 95% CI, 1.06-1.46), CHD mortality (HR,1.29; 95% CI, 1.02-1.62), CHD events (HR, 1.21; 95%CI, 0.99-1.46), and AF (HR, 1.68; 95% CI, 1.16-2.43).Risks did not differ significantly by age, sex, or preexisting cardiovascular disease and were similar after further adjustment for cardiovascular risk factors, with attributable risk of 14.5% for total mortality to 41.5% forAF in those with subclinical hyperthyroidism. Risks for CHD mortality and AF (but not other outcomes) were higher for thyrotropin level lower than 0.10 mIU/L compared with thyrotropin level between 0.10 and 0.44 mIU/L(for both, P value for trend, .03). CONCLUSION: Endogenous subclinical hyperthyroidism is associated with increased risks of total, CHD mortality, and incident AF, with highest risks of CHD mortality and AF when thyrotropin level is lower than 0.10 mIU/L.
Source: Archives of Internal Medicine
Authors: Tinh-Hai Collet, Jacobijn Gussekloo, Douglas C. Bauer, Wendy P. J. den Elzen, Anne R. Cappola, Philippe Balmer, Giorgio Iervasi, Bjørn O. Åsvold, José A. Sgarbi, Henry Völzke, Bariş Gencer, Rui M. B. Maciel, Sabrina Molinaro, Alexandra Bremner, Robert N. Luben, Patrick Maisonneuve, Jacques Cornuz, Anne B. Newman, Kay-Tee Khaw, Rudi G. J. Westendorp, Jayne A. Franklyn, Eric Vittinghoff, John P. Walsh, Nicolas Rodondi
Institutions: University of Lausanne, Leiden University, University of California, San Francisco, Norwegian University of Science and Technology, Leiden University Medical Center, University of Pennsylvania, Universidade Federal de São Paulo, Fondazione Toscana Gabriele Monasterio, Governo do Estado de São Paulo, Sir Charles Gairdner Hospital, Universität Greifswald, University of Cambridge, European Institute of Oncology, University of Pittsburgh, University of Birmingham, University of Bern, University Hospital of Bern
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: National Science Foundation, American Heart Association, University of Pittsburgh, Norges Teknisk-Naturvitenskapelige Universitet, Cancer Research UK, Deutsche Forschungsgemeinschaft, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Fundação de Amparo à Pesquisa do Estado de São Paulo, Bundesministerium für Bildung und Forschung, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, Universität Greifswald, Ministry of Cultural Affairs, National Institutes of Health, Medical Research Council, Norwegian Institute of Public Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Nursing Research, National Institute of Neurological Disorders and Stroke, National Institute of Arthritis and Musculoskeletal and Skin Diseases
Awards: G100949702, G1023702118, G10717269, G1220223050, G1224608327, G125972088, CORONARY HEART DISEASE AND STROKE, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G1401438683, DYNAMICS OF HEALTH,AGING, AND BODY COMPOSITION, CORONARY HEART DISEASE AND STROKE, CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84, G1890355377, G1909643007, G1916108176, G1951774866, Peripheral nerve decline: an underappreciated cause of injurious falls, DYNAMICS OF HEALTH, AGING, AND BODY COMPOSITION, G2194386449, CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G2245013492, G236442059, Exceptional Survival: Trajectories to Functional Aging (CHS All Stars), CORONARY HEART DISEASE &STROKE IN THE ELDERLY, G270907595, G277826483, G2786044735, G2800149121, G2882309788, Subclinical thyroid dysfunction in the elderly, Weinbau im Deutschwallis, G3137375862, G3145043064, HEALTH ABC--COORDINATING UNIT, G3370719899, G34347772, G3560915123, G3570525151, G3860090032, CENTRAL BLOOD ANALYSIS LABORATORY FOR CHS, Predictors of Alheimers Disease in Mild Cognitive Impairment, G4012114008, G4123730617, G423252844, G4365909528, Subcortical Hyperintensities in Sleep Apnea Syndrome, Cardiovascular and neuropsychiatric outcomes associated with subclinical thyroid dysfunction: a prospective evaluation, G4612575714, G4660668308, G4987078009, G5167412771, G537455924, G5612504302, G573134505, CHS Events Follow-up Study, G6226795708, G6401035755, End of Life in the Very Old, G670738241, CHS-Transition Phase, G6832344490, G687544517, G6923371013, G693548699, Rôle du neuropeptide Y (NPY) en relation avec la Noradrenaline dans les fibres sympathiques de la muqueuse nasale., G7201305826, G7286144250, CHS RETINAL READING CENTER, G764651519, G766700449, G766843672, Exceptional Survival: Trajectories to Functional Aging (CHS All Stars), G777822606, G7999488110, G806768229, Biomarker Research in Musculoskeleton Disease, COGNITIVE TESTS, APOE, BRAIN MRI AND RISKS OF DEMENTIA, G859984287, G861947890, Hormonal trajectories in aging, G880118091, Pittsburgh Older Americans Independence Center, G905887895, G936067872, G960597250
OpenAlex ID: W2113900128