Olaf M Dekkers1,2,3, Erzsébet Horváth-Puhó1, Suzanne C Cannegieter3, Jan P Vandenbroucke1,3, Henrik Toft Sørensen1, Jens Otto L Jørgensen4. 1. Department of Clinical EpidemiologyAarhus University Hospital, Aarhus, Denmark. 2. Department of Clinical Endocrinology and Metabolism. 3. Department of Clinical EpidemiologyLeiden University Medical Centre, Leiden, The Netherlands. 4. Department of Endocrinology and Internal MedicineAarhus University Hospital Aarhus, Aarhus, Denmark joj@clin.au.dk.
Abstract
OBJECTIVE: Several studies have shown an increased risk for cardiovascular disease (CVD) in hyperthyroidism, but most studies have been too small to address the effect of hyperthyroidism on individual cardiovascular endpoints. Our main aim was to assess the association among hyperthyroidism, acute cardiovascular events and mortality. DESIGN: It is a nationwide population-based cohort study. Data were obtained from the Danish Civil Registration System and the Danish National Patient Registry, which covers all Danish hospitals. We compared the rate of all-cause mortality as well as venous thromboembolism (VTE), acute myocardial infarction (AMI), ischemic and non-ischemic stroke, arterial embolism, atrial fibrillation (AF) and percutaneous coronary intervention (PCI) in the two cohorts. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated. RESULTS: The study included 85 856 hyperthyroid patients and 847 057 matched population-based controls. Mean follow-up time was 9.2 years. The HR for mortality was highest in the first 3 months after diagnosis of hyperthyroidism: 4.62, 95% CI: 4.40-4.85, and remained elevated during long-term follow-up (>3 years) (HR: 1.35, 95% CI: 1.33-1.37). The risk for all examined cardiovascular events was increased, with the highest risk in the first 3 months after hyperthyroidism diagnosis. The 3-month post-diagnosis risk was highest for atrial fibrillation (HR: 7.32, 95% CI: 6.58-8.14) and arterial embolism (HR: 6.08, 95% CI: 4.30-8.61), but the risks of VTE, AMI, ischemic and non-ischemic stroke and PCI were increased also 2- to 3-fold. CONCLUSIONS: We found an increased risk for all-cause mortality and acute cardiovascular events in patients with hyperthyroidism.
OBJECTIVE: Several studies have shown an increased risk for cardiovascular disease (CVD) in hyperthyroidism, but most studies have been too small to address the effect of hyperthyroidism on individual cardiovascular endpoints. Our main aim was to assess the association among hyperthyroidism, acute cardiovascular events and mortality. DESIGN: It is a nationwide population-based cohort study. Data were obtained from the Danish Civil Registration System and the Danish National Patient Registry, which covers all Danish hospitals. We compared the rate of all-cause mortality as well as venous thromboembolism (VTE), acute myocardial infarction (AMI), ischemic and non-ischemic stroke, arterial embolism, atrial fibrillation (AF) and percutaneous coronary intervention (PCI) in the two cohorts. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated. RESULTS: The study included 85 856 hyperthyroidpatients and 847 057 matched population-based controls. Mean follow-up time was 9.2 years. The HR for mortality was highest in the first 3 months after diagnosis of hyperthyroidism: 4.62, 95% CI: 4.40-4.85, and remained elevated during long-term follow-up (>3 years) (HR: 1.35, 95% CI: 1.33-1.37). The risk for all examined cardiovascular events was increased, with the highest risk in the first 3 months after hyperthyroidism diagnosis. The 3-month post-diagnosis risk was highest for atrial fibrillation (HR: 7.32, 95% CI: 6.58-8.14) and arterial embolism (HR: 6.08, 95% CI: 4.30-8.61), but the risks of VTE, AMI, ischemic and non-ischemic stroke and PCI were increased also 2- to 3-fold. CONCLUSIONS: We found an increased risk for all-cause mortality and acute cardiovascular events in patients with hyperthyroidism.
Authors: Eirini Marouli; Aleksander Kus; Fabiola Del Greco M; Layal Chaker; Robin Peeters; Alexander Teumer; Panos Deloukas; Marco Medici Journal: J Clin Endocrinol Metab Date: 2020-08-01 Impact factor: 5.958
Authors: Georgios Kostopoulos; Ioannis Doundoulakis; Christina Antza; Emmanouil Bouras; Krishnarajah Nirantharakumar; Dimitrios Tsiachris; G Neil Thomas; Gregory Y H Lip; Konstantinos A Toulis Journal: Endocr Relat Cancer Date: 2021-04-29 Impact factor: 5.678
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