Subclinical hyperthyroidism and the risk of coronary heart disease and mortality.

Détails

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Etat: Serval
Version: de l'auteur
ID Serval
serval:BIB_086D05510D9A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Subclinical hyperthyroidism and the risk of coronary heart disease and mortality.
Périodique
Archives of Internal Medicine
Auteur(s)
Collet T.H., Gussekloo J., Bauer D.C., den Elzen W.P., Cappola A.R., Balmer P., Iervasi G., Åsvold B.O., Sgarbi J.A., Völzke H., Gencer B., Maciel R.M., Molinaro S., Bremner A., Luben R.N., Maisonneuve P., Cornuz J., Newman A.B., Khaw K.T., Westendorp R.G., Franklyn J.A., Vittinghoff E., Walsh J.P., Rodondi N.
Collaborateur(s)
Thyroid Studies Collaboration
ISSN
0003-9926
1538-3679 (Electronic)
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
172
Numéro
10
Pages
799-809
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; ReviewPublication Status: ppublish
Résumé
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.
Mots-clé
Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Atrial Fibrillation/complications, Atrial Fibrillation/diagnosis, Cause of Death, Cohort Studies, Coronary Artery Disease/complications, Coronary Artery Disease/diagnosis, Female, Humans, Hyperthyroidism/complications, Hyperthyroidism/diagnosis, Male, Middle Aged, Prognosis, Prospective Studies, Risk Assessment, Severity of Illness Index, Sex Distribution, Survival Analysis, Switzerland, Thyroid Function Tests, Thyrotropin/blood, Young Adult
Pubmed
Web of science
Création de la notice
01/02/2013 14:25
Dernière modification de la notice
03/03/2018 13:29
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