Maximilian Zoltek1, Therese M-L Andersson2, Christel Hedman3,4, Catharina Ihre-Lundgren3,5, Caroline Nordenvall3,6. 1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. maximilian.zoltek@ki.se. 2. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 3. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 4. Stockholms Sjukhem Foundation's R&D Department, Stockholm, Sweden. 5. Department of Breast, Endocrine Tumours and Sarcoma, D2:02, Karolinska University Hospital, Stockholm, Sweden. 6. Center for Digestive Disease, Division of Coloproctology, D2:05, Karolinska University Hospital, Stockholm, Sweden.
Abstract
INTRODUCTION: To minimize recurrence risk in differentiated thyroid cancer (DTC), TSH is usually lifelong suppressed with levothyroxine. A common consequence of this treatment is subclinical hyperthyroidism which can induce cardiovascular disease (CV). This study's aim was to compare CV incidence in DTC patients with the general population in Sweden. MATERIALS AND METHODS: All Swedish patients diagnosed with DTC in 1987-2013 were included in the cohort study. Lifelong TSH suppression treatment was assumed to be administered to patients in compliance with prevalent national guidelines. Patients were followed from 1 year after DTC diagnosis until December 31, 2014, death, or migration. The event of interest was hospitalization due to any of the following diseases: atrial fibrillation (AF), cerebrovascular disease, cerebral infarction, ischemic heart disease, ischemic heart attack, and heart failure. Standardized incidence ratios (SIRs) were calculated to compare CV incidence between DTC patients and the general population. RESULTS: The cohort consisted of 6900 patients with DTC. Hospitalization was increased among DTC patients for AF (SIR 1.66, CI 95% 1.41-1.94), and women faced increased hospitalization for cerebrovascular disease (SIR 1.20 CI 95% 1.04-1.38). Regarding the remaining CV diseases, no consistent difference in SIR between the groups was observed. CONCLUSION: Compared to the general population, DTC patients have a higher incidence in AF, and female face a slightly higher incidence in cerebrovascular disease. However, there was no difference in hospitalization for other studied CV diseases between DTC patients and the general population.
INTRODUCTION: To minimize recurrence risk in differentiated thyroid cancer (DTC), TSH is usually lifelong suppressed with levothyroxine. A common consequence of this treatment is subclinical hyperthyroidism which can induce cardiovascular disease (CV). This study's aim was to compare CV incidence in DTC patients with the general population in Sweden. MATERIALS AND METHODS: All Swedish patients diagnosed with DTC in 1987-2013 were included in the cohort study. Lifelong TSH suppression treatment was assumed to be administered to patients in compliance with prevalent national guidelines. Patients were followed from 1 year after DTC diagnosis until December 31, 2014, death, or migration. The event of interest was hospitalization due to any of the following diseases: atrial fibrillation (AF), cerebrovascular disease, cerebral infarction, ischemic heart disease, ischemic heart attack, and heart failure. Standardized incidence ratios (SIRs) were calculated to compare CV incidence between DTC patients and the general population. RESULTS: The cohort consisted of 6900 patients with DTC. Hospitalization was increased among DTC patients for AF (SIR 1.66, CI 95% 1.41-1.94), and women faced increased hospitalization for cerebrovascular disease (SIR 1.20 CI 95% 1.04-1.38). Regarding the remaining CV diseases, no consistent difference in SIR between the groups was observed. CONCLUSION: Compared to the general population, DTC patients have a higher incidence in AF, and female face a slightly higher incidence in cerebrovascular disease. However, there was no difference in hospitalization for other studied CV diseases between DTC patients and the general population.
Authors: Esther N Klein Hesselink; Joop D Lefrandt; Edwin P Schuurmans; Johannes G M Burgerhof; Bart Groen; Ron T Gansevoort; Anouk N A van der Horst-Schrivers; Robin P F Dullaart; Isabelle C Van Gelder; Adrienne H Brouwers; Michiel Rienstra; Thera P Links Journal: J Clin Endocrinol Metab Date: 2015-10-19 Impact factor: 5.958
Authors: J W A Smit; C F A Eustatia-Rutten; E P M Corssmit; A M Pereira; M Frölich; G B Bleeker; E R Holman; E E van der Wall; J A Romijn; J J Bax Journal: J Clin Endocrinol Metab Date: 2005-08-30 Impact factor: 5.958
Authors: Randa M Abdulrahman; Victoria Delgado; Hendrieke C Hoftijzer; Arnold C T Ng; See Hooi Ewe; Nina Ajmone Marsan; Eduard R Holman; Guido C Hovens; Eleonora P Corssmit; Johannes A Romijn; Jeroen J Bax; Johannes W A Smit Journal: Thyroid Date: 2011-03-21 Impact factor: 6.568
Authors: Abdulgani Abonowara; Ata Quraishi; John L Sapp; Mohammed H Alqambar; Adi Saric; Colleen M O'Connell; Murali M Rajaraman; Robert D Hart; Syed A Imran Journal: Clin Invest Med Date: 2012-06-01 Impact factor: 0.825
Authors: McDonald K Horne; Kulvinder K Singh; Kathryn G Rosenfeld; Robert Wesley; Monica C Skarulis; Paula K Merryman; Ann Cullinane; Rene Costello; Amy Patterson; Thomas Eggerman; Donna M Bernstein; Frank Pucino; Gyorgy Csako Journal: J Clin Endocrinol Metab Date: 2004-09 Impact factor: 5.958
Authors: Tinh-Hai Collet; Jacobijn Gussekloo; Douglas C Bauer; Wendy P J den Elzen; Anne R Cappola; Philippe Balmer; Giorgio Iervasi; Bjørn O Åsvold; José A Sgarbi; Henry Völzke; Bariş Gencer; Rui M B Maciel; Sabrina Molinaro; Alexandra Bremner; Robert N Luben; Patrick Maisonneuve; Jacques Cornuz; Anne B Newman; Kay-Tee Khaw; Rudi G J Westendorp; Jayne A Franklyn; Eric Vittinghoff; John P Walsh; Nicolas Rodondi Journal: Arch Intern Med Date: 2012-05-28
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: Narcis Tribulova; Lin Hai Kurahara; Peter Hlivak; Katsuya Hirano; Barbara Szeiffova Bacova Journal: Int J Mol Sci Date: 2020-04-19 Impact factor: 5.923