Association between thyroid dysfunction and venous thromboembolism in the elderly: a prospective cohort study.

Détails

ID Serval
serval:BIB_D6D514606049
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Association between thyroid dysfunction and venous thromboembolism in the elderly: a prospective cohort study.
Périodique
Journal of thrombosis and haemostasis : JTH
Auteur(s)
Segna D., Méan M., Limacher A., Baumgartner C., Blum M.R., Beer J.H., Kucher N., Righini M., Matter C.M., Frauchiger B., Cornuz J., Aschwanden M., Banyai M., Osterwalder J., Husmann M., Egloff M., Staub D., Lämmle B., Angelillo-Scherrer A., Aujesky D., Rodondi N.
ISSN
1538-7836 (Electronic)
ISSN-L
1538-7836
Statut éditorial
Publié
Date de publication
04/2016
Peer-reviewed
Oui
Volume
14
Numéro
4
Pages
685-694
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Venous thromboembolism (VTE) and subclinical thyroid dysfunction (SCTD) are both common in elderly patients. SCTD has been related to a hypercoagulable state and an increased thromboembolic risk. However, prospective data on the relationship between SCTD and VTE are lacking.
To investigate the relationship between SCTD and recurrent VTE (rVTE), all-cause mortality, and thrombophilic biomarkers. Patients Elderly patients with VTE were studied.
In a prospective multicenter cohort, thyroid hormones and thrombophilic biomarkers were measured 1 year after acute VTE, as both may be influenced by acute thrombosis. We defined subclinical hypothyroidism (SHypo) as elevated thyroid-stimulating hormone (TSH) levels (4.50-19.99 mIU L(-1) ), and subclinical hyperthyroidism (SHyper) as TSH levels of < 0.45 mIU L(-1) , both with normal free thyroxine levels. Outcomes were incidence of rVTE and overall mortality during follow-up starting after the 1-year blood sampling.
Of 561 participants (58% with anticoagulation), 6% had SHypo and 5% had SHyper. After 20.8 months of mean follow-up, 9% developed rVTE and 10% died. The rVTE incidence rate was 7.2 (95% confidence interval [CI] 2.7-19.2) per 100 patient-years in SHypo participants, 0.0 (95% CI 0.0-7.6) in SHyper participants, and 5.9 (95% CI 4.4-7.8) in euthyroid participants. In multivariate analyses, the sub-hazard ratio for rVTE was 0.00 (95% CI 0.00-0.58) in SHyper participants and 1.50 (95% CI 0.52-4.34) in SHypo participants as compared with euthyroid participants, without increased levels of thrombophilic biomarkers. SHyper (hazard ratio [HR] 0.80, 95% CI 0.23-2.81) and SHypo (HR 0.99, 95% CI 0.30-3.29) were not associated with mortality.
In elderly patients, SHyper may be associated with lower rVTE risks. SHypo showed a non-statistically significant pattern of an association with rVTE, without increased mortality or differences in thrombophilic biomarkers.

Mots-clé
Aged, Aged, 80 and over, Biomarkers/blood, Blood Coagulation, Female, Humans, Hyperthyroidism/physiopathology, Hypothyroidism/physiopathology, Male, Middle Aged, Prospective Studies, Risk Factors, Thromboembolism, Thrombophilia/blood, Thrombosis/physiopathology, Thyroid Diseases/complications, Thyroid Diseases/mortality, Thyroid Diseases/physiopathology, Thyroid Gland/physiopathology, Thyrotropin/blood, Thyroxine/blood, Treatment Outcome, Venous Thromboembolism/complications, Venous Thromboembolism/mortality, Venous Thromboembolism/physiopathology
Pubmed
Création de la notice
28/05/2016 9:27
Dernière modification de la notice
21/10/2019 20:57
Données d'usage