Higher Risk of Incident Hyperthyroidism in Patients With Atrial Fibrillation

Author:

Huang Pang-Shuo123ORCID,Cheng Jen-Fang345ORCID,Chen Jien-Jiun1ORCID,Wang Yi-Chih35,Hwang Juey-Jen35ORCID,Wu Cho-Kai35ORCID,Tsai Chia-Ti35ORCID

Affiliation:

1. Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch , Yun-Lin 640 , Taiwan

2. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University , Taipei 100 , Taiwan

3. Cardiovascular Center, National Taiwan University Hospital , Taipei 100 , Taiwan

4. Division of Multidisciplinary Medicine, Department of Internal Medicine, National Taiwan University Hospital , Taipei 100 , Taiwan

5. Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital , Taipei 100 , Taiwan

Abstract

Abstract Background Atrial fibrillation (AF) has been linked to increased hyperthyroidism risk, but contributing factors are unclear. Objective We aimed to investigate whether AF could predict hyperthyroidism and related risk factors. Methods This retrospective cohort study was conducted in a tertiary medical institution and included patients aged 18 years or older with AF but without hyperthyroidism at diagnosis. The endpoint was defined as newly diagnosed hyperthyroidism during the follow-up period. Results The study cohort included 8552 participants. Patients who developed new hyperthyroidism were younger and the proportion of females was higher. They had fewer comorbidities, including diabetes (26% vs 29%, P = .121), hypertension (51% vs 58%, P < .001), coronary artery disease (17% vs 25%, P < .001), stroke (16% vs 22%, P < .001), and end-stage renal disease (ESRD) (6% vs 10%, P = .001). The CHADS2 score was lower in patients with hyperthyroidism (1.74 vs 2.05, P = .031), but there was no statistically significant difference in the CHA2DS2-VASc and HAS-BLED score. Cox regression analysis identified younger age, female gender, history of congestive heart failure, hypertension, diabetes, non-ESRD status, and lower CHADS2 score but not CHA2DS2-VASc as independent predictors of incident hyperthyroidism during follow-up. We also propose a novel, simple risk stratification score (SAD HEC2 score) with excellent predictive power for incident hyperthyroidism during follow-up. Conclusion Our results provide insight into clinical risk factors for the development of hyperthyroidism in AF patients, as identified by the novel SAD HEC2 score. AF appears to be a common precursor of hyperthyroidism.

Funder

National Taiwan University Hospital Yunlin Branch

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

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