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Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation.
Tuesday,2018-01-16 16:56 America/Los_Angeles — ecterry
| Title | Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation. |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Baumgartner, C, da Costa, BR, Collet, T-H, Feller, M, Floriani, C, Bauer, DC, Cappola, AR, Heckbert, SR, Ceresini, G, Gussekloo, J, Elzen, WPJ den, Peeters, RP, 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, Aujesky, D, Rodondi, N |
| Corporate/Institutional Authors | Thyroid Studies Collaboration, |
| Journal | Circulation |
| Volume | 136 |
| Issue | 22 |
| Pagination | 2100-2116 |
| Date Published | 2017 Nov 28 |
| ISSN | 1524-4539 |
| Keywords | Adult, Aged, Aged, 80 and over, Asymptomatic Diseases, Atrial Fibrillation, Biomarkers, Chi-Square Distribution, Female, Humans, Hypothyroidism, Incidence, Male, Middle Aged, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Risk Assessment, Risk Factors, Thyroid Function Tests, Thyroid Gland, Thyrotropin, Thyroxine, Time Factors, Young Adult |
| Abstract | <p><b>BACKGROUND: </b>Atrial fibrillation (AF) is a highly prevalent disorder leading to heart failure, stroke, and death. Enhanced understanding of modifiable risk factors may yield opportunities for prevention. The risk of AF is increased in subclinical hyperthyroidism, but it is uncertain whether variations in thyroid function within the normal range or subclinical hypothyroidism are also associated with AF.</p><p><b>METHODS: </b>We conducted a systematic review and obtained individual participant data from prospective cohort studies that measured thyroid function at baseline and assessed incident AF. Studies were identified from MEDLINE and EMBASE databases from inception to July 27, 2016. The euthyroid state was defined as thyroid-stimulating hormone (TSH) 0.45 to 4.49 mIU/L, and subclinical hypothyroidism as TSH 4.5 to 19.9 mIU/L with free thyroxine (fT4) levels within reference range. The association of TSH levels in the euthyroid and subclinical hypothyroid range with incident AF was examined by using Cox proportional hazards models. In euthyroid participants, we additionally examined the association between fT4 levels and incident AF.</p><p><b>RESULTS: </b>Of 30 085 participants from 11 cohorts (278 955 person-years of follow-up), 1958 (6.5%) had subclinical hypothyroidism and 2574 individuals (8.6%) developed AF during follow-up. TSH at baseline was not significantly associated with incident AF in euthyroid participants or those with subclinical hypothyroidism. Higher fT4 levels at baseline in euthyroid individuals were associated with increased AF risk in age- and sex-adjusted analyses (hazard ratio, 1.45; 95% confidence interval, 1.26-1.66, for the highest quartile versus the lowest quartile of fT4; P for trend ≤0.001 across quartiles). Estimates did not substantially differ after further adjustment for preexisting cardiovascular disease.</p><p><b>CONCLUSIONS: </b>In euthyroid individuals, higher circulating fT4 levels, but not TSH levels, are associated with increased risk of incident AF.</p> |
| DOI | 10.1161/CIRCULATIONAHA.117.028753 |
| Alternate Journal | Circulation |
| PubMed ID | 29061566 |
| PubMed Central ID | PMC5705446 |
| Grant List | N1AG62101A / AG / NIA NIH HHS / United States R01 HL070848 / HL / NHLBI NIH HHS / United States R01 HL071194 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States R01 HL070847 / HL / NHLBI NIH HHS / United States UL1 TR000128 / TR / NCATS NIH HHS / United States U01 HL130114 / HL / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States R01 HL070842 / HL / NHLBI NIH HHS / United States U01 AG042124 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States U01 AG042145 / AG / NIA NIH HHS / United States R01 NR012459 / NR / NINR NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States U01 AG042168 / AG / NIA NIH HHS / United States N1AG62103A / AG / NIA NIH HHS / United States R01 HL070841 / HL / NHLBI NIH HHS / United States U01 AG042140 / AG / NIA NIH HHS / United States R01 HL070838 / HL / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States R01 AG028050 / AG / NIA NIH HHS / United States N1AG62106A / AG / NIA NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States R01 HL070839 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States U01 AG027810 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States R01 HL070837 / HL / NHLBI NIH HHS / United States U01 AG042143 / AG / NIA NIH HHS / United States U01 AG042139 / AG / NIA NIH HHS / United States U01 AR066160 / AR / NIAMS NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States |
ePub date:
17/11