Higher Risk of Incident Hyperthyroidism in Patients With Atrial Fibrillation.
Asia
Atrial fibrillation
Hyperthyroidism
Risk score
Journal
The Journal of clinical endocrinology and metabolism
ISSN: 1945-7197
Titre abrégé: J Clin Endocrinol Metab
Pays: United States
ID NLM: 0375362
Informations de publication
Date de publication:
11 Aug 2023
11 Aug 2023
Historique:
received:
01
05
2023
revised:
19
07
2023
accepted:
27
07
2023
medline:
11
8
2023
pubmed:
11
8
2023
entrez:
11
8
2023
Statut:
aheadofprint
Résumé
Atrial fibrillation (AF) has been linked to increased hyperthyroidism risk, but contributing factors are unclear. 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 follow-up. The study cohort included 8,552 participants. Patients who developed new hyperthyroidism were younger and had a higher proportion of females. They had fewer comorbidities, including diabetes (26% vs 29%, p = 0.121), hypertension (51% vs 58%, p < 0.001), coronary artery disease (17% vs 25%, p < 0.001), stroke (16% vs 22%, p < 0.001), and end-stage renal disease (ESRD) (6% vs 10%, p = 0.001). The CHADS2 score was lower in patients with hyperthyroidism (1.74 vs 2.05, p = 0.031), 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. 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.
Sections du résumé
BACKGROUND
BACKGROUND
Atrial fibrillation (AF) has been linked to increased hyperthyroidism risk, but contributing factors are unclear.
METHODS
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 follow-up.
RESULTS
RESULTS
The study cohort included 8,552 participants. Patients who developed new hyperthyroidism were younger and had a higher proportion of females. They had fewer comorbidities, including diabetes (26% vs 29%, p = 0.121), hypertension (51% vs 58%, p < 0.001), coronary artery disease (17% vs 25%, p < 0.001), stroke (16% vs 22%, p < 0.001), and end-stage renal disease (ESRD) (6% vs 10%, p = 0.001). The CHADS2 score was lower in patients with hyperthyroidism (1.74 vs 2.05, p = 0.031), 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.
CONCLUSIONS
CONCLUSIONS
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.
Identifiants
pubmed: 37565329
pii: 7241057
doi: 10.1210/clinem/dgad448
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.