Mohammad Hussein1, Eman Toraih1,2, Adin S C Reisner3, Peter Miller3, Ralph Corsetti1, Emad Kandil1. 1. Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA. 2. Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. 3. Tulane University, School of Medicine, New Orleans, LA, USA.
Abstract
BACKGROUND: Little is known about the implications of hyperthyroidism on cardiovascular diseases like myocardial infarctions (MI), ischemic strokes, and hemorrhagic strokes. Previous studies implicate hyperthyroidism as a risk factor for MI and ischemic stroke. Cardiovascular disease is the leading cause of death in the US, and the possibility of hyperthyroidism contributing to this disease burden warrants investigation in a US patient population. METHODS: The National Readmission Database (NRD) from 2010 to 2017 was used to identify adults who had a new-onset diagnosis of MI, ischemic stroke, or hemorrhagic stroke. Risk factors for mortality, prolonged hospital stay, and hospital cost were analyzed with binary logistic regression. RESULTS: A total of 278,609,748 hospital records were reviewed. Of these, 15,685,461 were hospitalized for adverse cardiovascular events with concomitant hyperthyroidism, roughly 4.5 per 1,000 cases. Patients with MI and hemorrhagic stroke with thyrotoxicosis had a lower mortality rate than euthyroid patients (OR 0.81, 95% CI: 0.78-0.84, P<0.001 and OR 0.72, 95% CI: 0.67-0.77, P<0.001, respectively). Thyrotoxicosis was associated with increased hospital stay (MI: OR 1.35, 95% CI: 1.32-1.38, P<0.001; ischemic: OR 1.38, 95% CI: 1.35-1.41, P<0.001; hemorrhagic: OR 1.33, 95% CI: 1.25-1.40, P<0.001), expenditures in ischemic (OR 1.31, 95% CI: 1.28-1.34, P<0.001) and hemorrhagic stroke patients (OR 1.18, 95% CI: 1.12-1.24, P<0.001). CONCLUSIONS: Patients that experienced MI or hemorrhagic stroke with concomitant thyrotoxicosis were observed to have a lower mortality rate than euthyroid patients but had with an increased length of hospital stay. Patients who had ischemic or hemorrhagic stroke with thyrotoxicosis had a significantly higher hospital cost. The hyperdynamic state underlying hyperthyroidism may be protective in these adverse events. Further studies into these physiological changes are warranted. 2021 Gland Surgery. All rights reserved.
BACKGROUND: Little is known about the implications of hyperthyroidism on cardiovascular diseases like myocardial infarctions (MI), ischemic strokes, and hemorrhagic strokes. Previous studies implicate hyperthyroidism as a risk factor for MI and ischemic stroke. Cardiovascular disease is the leading cause of death in the US, and the possibility of hyperthyroidism contributing to this disease burden warrants investigation in a US patient population. METHODS: The National Readmission Database (NRD) from 2010 to 2017 was used to identify adults who had a new-onset diagnosis of MI, ischemic stroke, or hemorrhagic stroke. Risk factors for mortality, prolonged hospital stay, and hospital cost were analyzed with binary logistic regression. RESULTS: A total of 278,609,748 hospital records were reviewed. Of these, 15,685,461 were hospitalized for adverse cardiovascular events with concomitant hyperthyroidism, roughly 4.5 per 1,000 cases. Patients with MI and hemorrhagic stroke with thyrotoxicosis had a lower mortality rate than euthyroid patients (OR 0.81, 95% CI: 0.78-0.84, P<0.001 and OR 0.72, 95% CI: 0.67-0.77, P<0.001, respectively). Thyrotoxicosis was associated with increased hospital stay (MI: OR 1.35, 95% CI: 1.32-1.38, P<0.001; ischemic: OR 1.38, 95% CI: 1.35-1.41, P<0.001; hemorrhagic: OR 1.33, 95% CI: 1.25-1.40, P<0.001), expenditures in ischemic (OR 1.31, 95% CI: 1.28-1.34, P<0.001) and hemorrhagic stroke patients (OR 1.18, 95% CI: 1.12-1.24, P<0.001). CONCLUSIONS: Patients that experienced MI or hemorrhagic stroke with concomitant thyrotoxicosis were observed to have a lower mortality rate than euthyroid patients but had with an increased length of hospital stay. Patients who had ischemic or hemorrhagic stroke with thyrotoxicosis had a significantly higher hospital cost. The hyperdynamic state underlying hyperthyroidism may be protective in these adverse events. Further studies into these physiological changes are warranted. 2021 Gland Surgery. All rights reserved.
Authors: Faizel Osman; Jayne A Franklyn; Roger L Holder; Michael C Sheppard; Michael D Gammage Journal: J Am Coll Cardiol Date: 2006-12-13 Impact factor: 24.094
Authors: Nicholas W Setter; Marcos L Peres; Bernardo M M de Almeida; Ricardo R Petterle; Sonia M Raboni Journal: Intern Med J Date: 2020-06 Impact factor: 2.048
Authors: Emelia J Benjamin; Salim S Virani; Clifton W Callaway; Alanna M Chamberlain; Alexander R Chang; Susan Cheng; Stephanie E Chiuve; Mary Cushman; Francesca N Delling; Rajat Deo; Sarah D de Ferranti; Jane F Ferguson; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Pamela L Lutsey; Jason S Mackey; David B Matchar; Kunihiro Matsushita; Michael E Mussolino; Khurram Nasir; Martin O'Flaherty; Latha P Palaniappan; Ambarish Pandey; Dilip K Pandey; Mathew J Reeves; Matthew D Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Uchechukwu K A Sampson; Gary M Satou; Svati H Shah; Nicole L Spartano; David L Tirschwell; Connie W Tsao; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2018-01-31 Impact factor: 29.690
Authors: Paul A Heidenreich; Justin G Trogdon; Olga A Khavjou; Javed Butler; Kathleen Dracup; Michael D Ezekowitz; Eric Andrew Finkelstein; Yuling Hong; S Claiborne Johnston; Amit Khera; Donald M Lloyd-Jones; Sue A Nelson; Graham Nichol; Diane Orenstein; Peter W F Wilson; Y Joseph Woo Journal: Circulation Date: 2011-01-24 Impact factor: 29.690
Authors: P A Singer; D S Cooper; E G Levy; P W Ladenson; L E Braverman; G Daniels; F S Greenspan; I R McDougall; T F Nikolai Journal: JAMA Date: 1995-03-08 Impact factor: 56.272