Author:
Zoltek Maximilian,Andersson Therese M.-L.,Hedman Christel,Ihre-Lundgren Catharina,Nordenvall Caroline
Abstract
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.
Publisher
Springer Science and Business Media LLC
Reference21 articles.
1. Cabanillas ME, McFadden DG, Durante C (2016) Thyroid cancer. Lancet 388:2783–2795
2. Lundgren CI, Hall P, Ekbom A et al (2003) Incidence and survival of Swedish patients with differentiated thyroid cancer. Int J Cancer 106:569–573
3. Hundahl SA, Fleming ID, Fremgen AM et al (1998) A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995 [see commetns]. Cancer 83:2638–2648
4. Pujol P, Daures JP, Nsakala N et al (1996) Degree of thyrotropin suppression as a prognostic determinant in differentiated thyroid cancer. J Clin Endocrinol Metab 81:4318–4323
5. Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 26:1–133
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