Subclinical thyroid dysfunction and cardiovascular outcomes among prospective cohort studies.

Détails

Ressource 1Télécharger: 5_23369133_Postprint.pdf (834.58 [Ko])
Etat: Public
Version: Author's accepted manuscript
ID Serval
serval:BIB_2ACFBC669620
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Subclinical thyroid dysfunction and cardiovascular outcomes among prospective cohort studies.
Périodique
Endocr. Metab. Immune Disord. Drug Targets
Auteur(s)
Gencer Baris, Collet Tinh-Hai, Virgini Vanessa, Auer Reto, Rodondi Nicolas
ISSN
1871-5303
Statut éditorial
Publié
Date de publication
03/2013
Peer-reviewed
Oui
Volume
13
Numéro
1
Pages
4-12
Langue
anglais
Résumé
The association between subclinical thyroid dysfunction and cardiovascular outcomes has been recently clarified with the publication of three individual participant data (IPD) analyses from the Thyroid Studies Collaboration. We identified original cohort studies with a systematic review and pooled individual data from over 70'000 participants to obtain a more precise estimate of the risks of cardiovascular outcomes associated with subclinical thyroid dysfunction. Subclinical hypothyroidism and subclinical hyperthyroidism, defined as normal thyroxine (FT4) levels with increased or decreased Thyroid-Stimulating Hormones (TSH or thyrotropin) respectively, are associated with increased risk of cardiovascular outcomes compared to euthyroid state, particularly in those with a more pronounced thyroid dysfunction. Specifically, subclinical hypothyroidism is associated with an increased risk of coronary heart disease (CHD) events, CHD mortality and heart failure (HF) events in individuals with higher TSH levels, particularly in those with TSH levels ≥10.0 mIU/L. Conversely, subclinical hyperthyroidism is associated with an increased risk of total mortality, CHD mortality, HF and atrial fibrillation, particularly in those with suppressed TSH levels <0.10 mIU/L. Pending ongoing randomized controlled trials, these observational findings allow identifying potential TSH thresholds for thyroid medication initiation based on risk of clinical outcomes, although clinical decision based solely on observational data need caution. The impact of thyroid replacement among the elderly with subclinical hypothyroidism is currently studied in a multicenter international randomized controlled trial (Thyroid Hormone Replacement for Subclinical Hypothyroidism Trial, TRUST trial).
Pubmed
Open Access
Oui
Création de la notice
15/09/2017 16:23
Dernière modification de la notice
20/08/2019 13:10
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