Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation.

Détails

ID Serval
serval:BIB_81A47B32CF4E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation.
Périodique
Circulation
Auteur(s)
Baumgartner C., da Costa B.R., Collet T.H., Feller M., Floriani C., Bauer D.C., Cappola A.R., Heckbert S.R., Ceresini G., Gussekloo J., den Elzen WPJ, Peeters R.P., Luben R., Völzke H., Dörr M., Walsh J.P., Bremner A., Iacoviello M., Macfarlane P., Heeringa J., Stott D.J., Westendorp RGJ, Khaw K.T., Magnani J.W., Aujesky D., Rodondi N.
Collaborateur(s)
Thyroid Studies Collaboration
ISSN
1524-4539 (Electronic)
ISSN-L
0009-7322
Statut éditorial
Publié
Date de publication
28/11/2017
Peer-reviewed
Oui
Volume
136
Numéro
22
Pages
2100-2116
Langue
anglais
Notes
Publication types: Journal Article ; Meta-Analysis ; Review
Publication Status: ppublish
Résumé
Atrial fibrillation (AF) is a highly prevalent disorder leading to heart failure, stroke, and death. Enhanced understanding of modifiable risk factors may yield opportunities for prevention. The risk of AF is increased in subclinical hyperthyroidism, but it is uncertain whether variations in thyroid function within the normal range or subclinical hypothyroidism are also associated with AF.
We conducted a systematic review and obtained individual participant data from prospective cohort studies that measured thyroid function at baseline and assessed incident AF. Studies were identified from MEDLINE and EMBASE databases from inception to July 27, 2016. The euthyroid state was defined as thyroid-stimulating hormone (TSH) 0.45 to 4.49 mIU/L, and subclinical hypothyroidism as TSH 4.5 to 19.9 mIU/L with free thyroxine (fT4) levels within reference range. The association of TSH levels in the euthyroid and subclinical hypothyroid range with incident AF was examined by using Cox proportional hazards models. In euthyroid participants, we additionally examined the association between fT4 levels and incident AF.
Of 30 085 participants from 11 cohorts (278 955 person-years of follow-up), 1958 (6.5%) had subclinical hypothyroidism and 2574 individuals (8.6%) developed AF during follow-up. TSH at baseline was not significantly associated with incident AF in euthyroid participants or those with subclinical hypothyroidism. Higher fT4 levels at baseline in euthyroid individuals were associated with increased AF risk in age- and sex-adjusted analyses (hazard ratio, 1.45; 95% confidence interval, 1.26-1.66, for the highest quartile versus the lowest quartile of fT4; P for trend ≤0.001 across quartiles). Estimates did not substantially differ after further adjustment for preexisting cardiovascular disease.
In euthyroid individuals, higher circulating fT4 levels, but not TSH levels, are associated with increased risk of incident AF.

Mots-clé
Adult, Aged, Aged, 80 and over, Asymptomatic Diseases, Atrial Fibrillation/diagnosis, Atrial Fibrillation/epidemiology, Biomarkers/blood, Chi-Square Distribution, Female, Humans, Hypothyroidism/blood, Hypothyroidism/diagnosis, Hypothyroidism/epidemiology, Hypothyroidism/physiopathology, Incidence, Male, Middle Aged, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Risk Assessment, Risk Factors, Thyroid Function Tests, Thyroid Gland/metabolism, Thyroid Gland/physiopathology, Thyrotropin/blood, Thyroxine/blood, Time Factors, Young Adult, atrial fibrillation, hypothyroidism, thyrotropin, thyroxine
Pubmed
Web of science
Open Access
Oui
Création de la notice
02/11/2017 12:32
Dernière modification de la notice
08/05/2019 21:10
Données d'usage