Abstract
Aims:
This retrospective study investigated the occurrence of major adverse cardiovascular events (MACE) in thyroxine using diabetic patients and compared the risk factors between the MACE and non-MACE groups.
Methods:
We used longitudinal claims data from 2008 to 2017 from the Chang Gung Research Database. Diabetic patients who used thyroxine were included. The primary outcome was the occurrence of MACE. The secondary outcomes were the differences between the two groups (MACE vs. no MACE).
Results:
After 1:1 group matching by propensity score between MACE and non-MACE group by sex, age, the interval of using thyroxine, there were 416 patients in each group. Patients with worse renal function (eGFR < 45 ml/min/1.73 m2), hypertension, history of diabetic microvascular complications, end stage renal disease (ESRD), coronary heart disease (CHD), heart failure, cerebrovascular accident (CVA) and diabetic foot infection had a higher risk of experiencing MACE. Free T4 had weak positive correlation with HDL, and TSH had weak positive correlation with LDL and negative correlation with HDL (correlation coefficient, p value: 0.131, 0.022; 0.124, 0.016; -0.157, 0.003, respectively). There’s no optimal cutoff points according to the Receiver operating characteristic (ROC) curve analysis of the best discrimination point between TSH/free T4/LDL and MACE attack.
Conclusions:
In thyroxine using diabetic patients, patients with worse renal function, hypertension, history of diabetic microvascular complications, ESRD, CHD, heart failure, CVA and diabetic foot infection had a higher risk of experiencing MACE, but peripheral artery disease (PAD) was not a significant risk of MACE.