ICEECE2012 Oral Communications Thyroid Clinical 2 (6 abstracts)
Subclinical thyroid disease and risk of new-onset atrial fibrillation
C. Selmer 1 , J. Olesen 1 , J. Lindhardsen 1 , A. Olsen 1 , J. Madsen 4 , U. Schmidt 2 , J. Faber 2 , P. Hansen 1 , O. Pedersen 3 , M. Hansen 1 , C. Torp-Pedersen 1 & G. Gislason 1
1University Hospital Gentofte, Hellerup, Denmark; 2University Hospital Herlev, Herlev, Denmark; 3University Hospital Roskilde, Roskilde, Denmark; 4Copenhagen General Practitioners Laboratory, Copenhagen, Denmark.
Background: It is still uncertain if subclinical thyroid disease or ‘high-normal’ thyroid function are risk-factors for atrial fibrillation (AF).
Objectives: To examine the risk of AF in relation to thyroid function.
Methods: Patients consulting their general practitioner from 2000–2009 in Copenhagen, Denmark, who underwent thyroid blood tests, were identified by individual-level linkage of nationwide registries. Patients with a history of thyroid disease, AF or related medication were excluded. Risk of AF was analyzed using cumulative incidence plots and Poisson regression models to gain Incidence Rate Ratios (IRR).
Results: Of 525,100 individuals in the study population (mean age 51.7 years [S.D. ±18.0]; 39.5% males) 504,113 (96.0%) were euthyroid, 1474 (0.3%) had clinical hypothyroidism, 10,679 (2.0%) subclinical hypothyroidism, 3421 (0.7%) clinical hyperthyroidism and 5414 (1.0%) subclinical hyperthyroidism. A ‘dose-dependent’ increased risk of AF was found in two levels of subclinical hyperthyroidism (TSH <0.1, 0.1–0.2 mU/l): IRR 1.8 [95% CI: 1.5–2.2], IRR 1.5 [1.2–2.0] and in ‘high-normal’ levels of euthyroidism (TSH 0.2–0.4 mU/l): IRR 1,3 [1.2–1.5]. Both clinical and subclinical hypothyroidism was associated with a lower risk of AF.
Conclusions: Subclinical hyperthyroidism and ‘high-normal’ thyroid function is a significant risk-factor for AF, whereas hypothyroidism is associated with decreased risk of AF.
Fig 1 Cumulative incidence of atrial fibrillation in relation to thyroid function (age≥65 years)
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
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