Prognostic implications of thyroid disease in patients with atrial fibrillation
-
Published:2023-12-13
Issue:2
Volume:39
Page:185-193
-
ISSN:0910-8327
-
Container-title:Heart and Vessels
-
language:en
-
Short-container-title:Heart Vessels
Author:
Vasilopoulou Anthi, Patsiou Vasiliki, Bekiaridou Alexandra, Papazoglou Andreas S., Moysidis Dimitrios V., Spaho Marina, Zergioti Martha, Kostakakis Dimitrios, Kyriakideli Maria-Eirini, Lampropoulou Chrysanthi-Ioanna, Kartas Anastasios, Samaras Athanasios, Baroutidou Amalia, Tzikas Apostolos, Ziakas Antonios, Giannakoulas GeorgeORCID
Abstract
AbstractAtrial fibrillation (AF) is often accompanied by thyroid disease (THD). This study aimed to explore the relationship between THD and the occurrence of significant clinical outcomes in patients with AF. This post hoc analysis utilized data from the MISOAC-AF trial (NCT02941978), which enrolled hospitalized patients with AF. Patients were categorized based on their THD history into hyperthyroidism, hypothyroidism, or euthyroidism. Cox regression models were employed to calculate unadjusted and adjusted hazard ratios (aHRs). The primary outcomes of interest included all-cause mortality, cardiovascular death, and hospitalizations during the follow-up period. The study included 496 AF patients (mean age 73.09 ± 11.10 years) with available THD data, who were followed-up for a median duration of 31 months. Among them, 16 patients (3.2%) had hyperthyroidism, 141 (28.4%) had hypothyroidism, and 339 (68.4%) had no thyroid disease. Patients with hypothyroidism exhibited higher rates of hospitalization during follow-up (aHR: 1.57, 95% CI 1.12 to 2.20, p = 0.025) compared to the euthyroid group. Elevated levels of thyroid-stimulating hormone (TSH) were correlated with an increased risk of cardiovascular mortality (aHR: 1.03, 95% CI 1.01 to 1.05, p = 0.007) and hospitalizations (aHR: 1.06, 95% CI 1.01 to 1.12, p = 0.03). Conversely, lower levels of triiodothyronine (T3) were associated with higher risks of all-cause mortality (aHR: 0.51, 95% CI 0.31 to 0.82, p = 0.006) and cardiovascular mortality (aHR: 0.42, 95% CI 0.23 to 0.77, p = 0.005). Among patients with AF, hypothyroidism was associated with increased hospitalizations. Furthermore, elevated TSH levels and decreased T3 levels were linked to higher cardiovascular and all-cause mortality risks, respectively.
Funder
Aristotle University of Thessaloniki
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Reference41 articles.
1. Lippi G, Sanchis-Gomar F, Cervellin G (2021) Global epidemiology of atrial fibrillation: an increasing epidemic and public health challenge. Int J Stroke 16(2):217–221 2. Baumgartner C, da Costa B, Collet T, Feller M, Floriani C, Bauer D, Cappola A, Heckbert S, Ceresini G, Gussekloo J, Wendy PJ, den Elzen W, Peeters R, Luben R, Völzke H, Dörr M, Walsh JP, Bremner A, Iacoviello M, Macfarlane P, Heeringa J, Stott DJ, Westendorp RGJ, Khaw K-T, Magnani JW, Drahomir Aujesky D, Rodondi N (2017) Thyroid Function Within the Normal Range, Subclinical Hypothyroidism and the Risk of Atrial Fibrillation. Circulation 136(22):2100 3. Kim EJ, Lyass A, Wang N, Massaro JM, Fox CS, Benjamin EJ, Magnani JW (2014) Relation of Hypothyroidism and incident atrial fibrillation (from the Framingham Heart Study). Am Heart J 167(1):123–126 4. Sussman MA (2001) When the thyroid speaks, the heart listens. Circ Res 89(7):557–559 5. Wang K, Ojamaa K, Samuels A, Gilani N, Zhang K, An S, Zhang Y, Tang Y-D, Askari B, Gerdes AM (2020) BNP as a new biomarker of cardiac thyroid hormone function. Front Physiol 11:729
|
|