OBJECTIVE: Previous studies suggest that patients with hyperthyroidism remain at an increased risk of cardiovascular morbidity even after restoring euthyroidism. The mechanisms of the increased risk and its dependency on the different treatment modalities of hyperthyroidism remain unclear. The aim of this long-term follow-up study was to compare the rate of hospitalizations for cardiovascular causes and the mortality in hyperthyroid patients treated surgically with an age- and gender-matched reference population. PATIENTS AND MEASUREMENTS: A population-based cohort study was conducted among 4334 hyperthyroid patients (median age 46 years) treated with thyroidectomy in 1986-2007 in Finland and among 12,991 reference subjects. Firstly, the hospitalizations due to cardiovascular diseases (CVD) were analysed until thyroidectomy. Secondly, the hazard ratios for any new hospitalization due to CVDs after the thyroidectomy were calculated in Cox regression analysis adjusted with the prevalent CVDs at the time of thyroidectomy. RESULTS: The risk of hospitalization due to all CVDs started to increase already 5 years before the thyroidectomy, and by the time of the operation, it was 50% higher in the hyperthyroid patients compared to the controls (P < 0·001). After the thyroidectomy, the hospitalizations due to all CVDs (HR 1·15), hypertension (HR 1·23), heart failure (HR 1·17) and valvular diseases or cardiomyopathies (HR 1·55) remained more frequent among the patients than among the controls for 20 years after thyroidectomy. The increased morbidity was not clearly related to the aetiology of hyperthyroidism. Despite the increased CVD morbidity among the patients, there was no difference in cardiovascular mortality. CONCLUSIONS: The present study shows that hyperthyroidism increases the risk of hospitalization due to CVDs and the risk is sustained up to two decades after effective surgical treatment. However, there was no excess CVD mortality in the middle-aged patient cohort studied.
OBJECTIVE: Previous studies suggest that patients with hyperthyroidism remain at an increased risk of cardiovascular morbidity even after restoring euthyroidism. The mechanisms of the increased risk and its dependency on the different treatment modalities of hyperthyroidism remain unclear. The aim of this long-term follow-up study was to compare the rate of hospitalizations for cardiovascular causes and the mortality in hyperthyroidpatients treated surgically with an age- and gender-matched reference population. PATIENTS AND MEASUREMENTS: A population-based cohort study was conducted among 4334 hyperthyroidpatients (median age 46 years) treated with thyroidectomy in 1986-2007 in Finland and among 12,991 reference subjects. Firstly, the hospitalizations due to cardiovascular diseases (CVD) were analysed until thyroidectomy. Secondly, the hazard ratios for any new hospitalization due to CVDs after the thyroidectomy were calculated in Cox regression analysis adjusted with the prevalent CVDs at the time of thyroidectomy. RESULTS: The risk of hospitalization due to all CVDs started to increase already 5 years before the thyroidectomy, and by the time of the operation, it was 50% higher in the hyperthyroidpatients compared to the controls (P < 0·001). After the thyroidectomy, the hospitalizations due to all CVDs (HR 1·15), hypertension (HR 1·23), heart failure (HR 1·17) and valvular diseases or cardiomyopathies (HR 1·55) remained more frequent among the patients than among the controls for 20 years after thyroidectomy. The increased morbidity was not clearly related to the aetiology of hyperthyroidism. Despite the increased CVD morbidity among the patients, there was no difference in cardiovascular mortality. CONCLUSIONS: The present study shows that hyperthyroidism increases the risk of hospitalization due to CVDs and the risk is sustained up to two decades after effective surgical treatment. However, there was no excess CVD mortality in the middle-aged patient cohort studied.
Authors: Joe-Elie Salem; M Benjamin Shoemaker; Lisa Bastarache; Christian M Shaffer; Andrew M Glazer; Brett Kroncke; Quinn S Wells; Mingjian Shi; Peter Straub; Gail P Jarvik; Eric B Larson; Digna R Velez Edwards; Todd L Edwards; Lea K Davis; Hakon Hakonarson; Chunhua Weng; David Fasel; Bjorn C Knollmann; Thomas J Wang; Joshua C Denny; Patrick T Ellinor; Dan M Roden; Jonathan D Mosley Journal: JAMA Cardiol Date: 2019-02-01 Impact factor: 14.676
Authors: Christina Ellervik; Carolina Roselli; Ingrid E Christophersen; Alvaro Alonso; Maik Pietzner; Collen M Sitlani; Stella Trompet; Dan E Arking; Bastiaan Geelhoed; Xiuqing Guo; Marcus E Kleber; Henry J Lin; Honghuang Lin; Peter MacFarlane; Elizabeth Selvin; Christian Shaffer; Albert V Smith; Niek Verweij; Stefan Weiss; Anne R Cappola; Marcus Dörr; Vilmundur Gudnason; Susan Heckbert; Simon Mooijaart; Winfried März; Bruce M Psaty; Paul M Ridker; Dan Roden; David J Stott; Henry Völzke; Emelia J Benjamin; Graciela Delgado; Patrick Ellinor; Georg Homuth; Anna Köttgen; Johan W Jukema; Steven A Lubitz; Samia Mora; Michiel Rienstra; Jerome I Rotter; M Benjamin Shoemaker; Nona Sotoodehnia; Kent D Taylor; Pim van der Harst; Christine M Albert; Daniel I Chasman Journal: JAMA Cardiol Date: 2019-02-01 Impact factor: 14.676