Endocrine Abstracts

Background: Graves disease is an autonomous condition characterised by interaction of the TSH receptor with autoantibody(TRAb). It is well recognised that atrial fibrillation (AF) is a consequence of hyperthyroidism but the prevalence, predictors and outcomes of AF in patients with Graves hyperthyroidism is not completely known.

Method: We analysed a prospective database of Graves disease patients over a 16 year period from October 2007 till June 2023 with the aim of estimating the prevalence of AF and to analyse factors that predict its development. In addition, we performed statistical analyses to assess if echocardiographic parameters were related to conversion to sinus rhythm.

Results: AF was observed in 48 (6.4%) patients out of 749 new patients with hyperthyroidism due to Graves disease. The independent predictor of AF were older age (OR 1.21), higher FT4 levels (OR 1.03), male sex (OR 1.58) and current smokers (OR 2.86). Poor Left ventricular function and higher atrial diameter on echocardiography were significant predictors of persistent or permanent AF.

Discussion: The results above showed that almost 1 in 16 people with hyperthyroidism presents with AF. This analysis has identified patients at higher risk of developing and remaining in AF. A close interaction between endocrinologists and cardiologists is needed to improve the management of these patients.