Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts.

Détails

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Etat: Public
Version: de l'auteur
ID Serval
serval:BIB_57B186D69971
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts.
Périodique
Circulation
Auteur(s)
Gencer B., Collet T.H., Virgini V., Bauer D.C., Gussekloo J., Cappola A.R., Nanchen D., den Elzen W.P., Balmer P., Luben R.N., Iacoviello M., Triggiani V., Cornuz J., Newman A.B., Khaw K.T., Jukema J.W., Westendorp R.G., Vittinghoff E., Aujesky D., Rodondi N.
Collaborateur(s)
Thyroid Studies Collaboration
ISSN
1524-4539 (Electronic)
ISSN-L
0009-7322
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
126
Numéro
9
Pages
1040-1049
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Résumé
BACKGROUND: American College of Cardiology/American Heart Association guidelines for the diagnosis and management of heart failure recommend investigating exacerbating conditions such as thyroid dysfunction, but without specifying the impact of different thyroid-stimulation hormone (TSH) levels. Limited prospective data exist on the association between subclinical thyroid dysfunction and heart failure events.
METHODS AND RESULTS: We performed a pooled analysis of individual participant data using all available prospective cohorts with thyroid function tests and subsequent follow-up of heart failure events. Individual data on 25 390 participants with 216 248 person-years of follow-up were supplied from 6 prospective cohorts in the United States and Europe. Euthyroidism was defined as TSH of 0.45 to 4.49 mIU/L, subclinical hypothyroidism as TSH of 4.5 to 19.9 mIU/L, and subclinical hyperthyroidism as TSH <0.45 mIU/L, the last two with normal free thyroxine levels. Among 25 390 participants, 2068 (8.1%) had subclinical hypothyroidism and 648 (2.6%) had subclinical hyperthyroidism. In age- and sex-adjusted analyses, risks of heart failure events were increased with both higher and lower TSH levels (P for quadratic pattern <0.01); the hazard ratio was 1.01 (95% confidence interval, 0.81-1.26) for TSH of 4.5 to 6.9 mIU/L, 1.65 (95% confidence interval, 0.84-3.23) for TSH of 7.0 to 9.9 mIU/L, 1.86 (95% confidence interval, 1.27-2.72) for TSH of 10.0 to 19.9 mIU/L (P for trend <0.01) and 1.31 (95% confidence interval, 0.88-1.95) for TSH of 0.10 to 0.44 mIU/L and 1.94 (95% confidence interval, 1.01-3.72) for TSH <0.10 mIU/L (P for trend=0.047). Risks remained similar after adjustment for cardiovascular risk factors.
CONCLUSION: Risks of heart failure events were increased with both higher and lower TSH levels, particularly for TSH ≥10 and <0.10 mIU/L.
Mots-clé
Adult, Aged, Aged, 80 and over, Comorbidity, Female, Follow-Up Studies, Heart Failure/epidemiology, Humans, Hypothyroidism/blood, Hypothyroidism/epidemiology, Male, Middle Aged, Prospective Studies, Risk, Risk Factors, Sensitivity and Specificity, Thyrotropin/blood, Thyroxine/blood
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/01/2013 18:11
Dernière modification de la notice
20/08/2019 14:11
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