OBJECTIVE: To clarify whether hyperthyroidism (HT) itself confers an additional effect on the hypercoagulable state and the risk of ischemic stroke among patients with hyperthyroid atrial fibrillation (AF). METHODS: We prospectively evaluated plasma D-dimer levels and thromboembolic events among three groups of patients (hyperthyroid AF, n = 62; nonthyroid AF, n = 107, and HT without AF, n = 100). Plasma D-dimer levels were used to evaluate the hypercoagulable state. RESULTS: The D-dimer level was significantly higher in patients with hyperthyroid AF than in nonthyroid AF (0.66 ± 0.06 vs. 0.34 ± 0.02 mg/l, p < 0.001) and HT without AF (0.66 ± 0.06 vs. 0.27 ± 0.02 mg/l, p < 0.001). During a 3-year follow-up, patients with hyperthyroid AF had a significantly higher incidence of ischemic stroke compared with patients with nonthyroid AF (hazard ratio, HR: 3.2, 95% confidence interval, CI: 1.01-5.59, p = 0.04). Cox regression analysis revealed that age (HR: 2.5, 95% CI: 1.01-1.21, p = 0.05), CHADS2-VAS score (HR: 5.5, 95% CI: 1.51-7.43, p = 0.01) and anticoagulation (HR: 0.45, 95% CI: 0.07-0.54, p = 0.01) were independent predictors of risk for the occurrence of ischemic stroke. CONCLUSIONS: The present study suggests that HT may enhance the hypercoagulable state and the risk of ischemic stroke in patients with AF.
OBJECTIVE: To clarify whether hyperthyroidism (HT) itself confers an additional effect on the hypercoagulable state and the risk of ischemic stroke among patients with hyperthyroid atrial fibrillation (AF). METHODS: We prospectively evaluated plasma D-dimer levels and thromboembolic events among three groups of patients (hyperthyroid AF, n = 62; nonthyroid AF, n = 107, and HT without AF, n = 100). Plasma D-dimer levels were used to evaluate the hypercoagulable state. RESULTS: The D-dimer level was significantly higher in patients with hyperthyroid AF than in nonthyroid AF (0.66 ± 0.06 vs. 0.34 ± 0.02 mg/l, p < 0.001) and HT without AF (0.66 ± 0.06 vs. 0.27 ± 0.02 mg/l, p < 0.001). During a 3-year follow-up, patients with hyperthyroid AF had a significantly higher incidence of ischemic stroke compared with patients with nonthyroid AF (hazard ratio, HR: 3.2, 95% confidence interval, CI: 1.01-5.59, p = 0.04). Cox regression analysis revealed that age (HR: 2.5, 95% CI: 1.01-1.21, p = 0.05), CHADS2-VAS score (HR: 5.5, 95% CI: 1.51-7.43, p = 0.01) and anticoagulation (HR: 0.45, 95% CI: 0.07-0.54, p = 0.01) were independent predictors of risk for the occurrence of ischemic stroke. CONCLUSIONS: The present study suggests that HT may enhance the hypercoagulable state and the risk of ischemic stroke in patients with AF.
Authors: Alexander Weymann; Anton Sabashnikov; Sadeq Ali-Hasan-Al-Saegh; Aron-Frederik Popov; Seyed Jalil Mirhosseini; William L Baker; Mohammadreza Lotfaliani; Tong Liu; Hamidreza Dehghan; Senol Yavuz; Michel Pompeu Barros de Oliveira Sá; Jae-Sik Jang; Mohamed Zeriouh; Lei Meng; Fabrizio D'Ascenzo; Abhishek J Deshmukh; Guiseppe Biondi-Zoccai; Pascal M Dohmen; Hugh Calkins; Integrated Meta-Analysis Of Cardiac Cardiac Surgery And Cardiology-Group Imcsc-Group Journal: Med Sci Monit Basic Res Date: 2017-03-31
Authors: Lena M O'Keefe; Sarah E Conway; Alexandra Czap; Carl D Malchoff; Sharon Benashski; Gilbert Fortunato; Ilene Staff; Louise D McCullough Journal: Thyroid Res Date: 2015-07-04