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New-onset atrial fibrillation is a predictor of subsequent hyperthyroidism: a nationwide cohort study.

Selmer C, Hansen ML, Olesen JB, Mérie C, Lindhardsen J, Olsen AM, Madsen JC, Schmidt U, Faber J, Hansen PR, Pedersen OD, Torp-Pedersen C, Gislason GH - PLoS ONE (2013)

Bottom Line: Non-AF individuals from the general population served as reference.In both women and men we found a significantly increased risk of hyperthyroidism associated with new-onset AF compared to individuals in the general population.The highest risk was found in middle-aged men and was consistently increased throughout the 13-year period of observation.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark. cselmer@gmail.com

ABSTRACT

Aims: To examine the long-term risk of hyperthyroidism in patients admitted to hospital with new-onset AF. Hyperthyroidism is a well-known risk factor for atrial fibrillation (AF), but it is unknown whether new-onset AF predicts later-occurring hyperthyroidism.

Methods and results: All patients admitted with new-onset AF in Denmark from 1997-2009, and their present and subsequent use of anti-thyroid medication was identified by individual-level linkage of nationwide registries. Patients with previous thyroid diagnosis or thyroid medication use were excluded. Development of hyperthyroidism was assessed as initiation of methimazole or propylthiouracil up to a 13-year period. Risk of hyperthyroidism was analysed by Poisson regression models adjusted for important confounders such as amiodarone treatment. Non-AF individuals from the general population served as reference. A total of 145,623 patients with new-onset AF were included (mean age 66.4 years [SD ±13.2] and 55.3% males) of whom 3% (4,620 events; 62.2% women) developed hyperthyroidism in the post-hospitalization period compared to 1% (48,609 events; 82% women) in the general population (n = 3,866,889). In both women and men we found a significantly increased risk of hyperthyroidism associated with new-onset AF compared to individuals in the general population. The highest risk was found in middle-aged men and was consistently increased throughout the 13-year period of observation. The results were confirmed in a substudy analysis of 527,352 patients who had thyroid screening done.

Conclusion: New-onset AF seems to be a predictor of hyperthyroidism. Increased focus on subsequent risk of hyperthyroidism in patients with new-onset AF is warranted.

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Related in: MedlinePlus

Flowchart of study cohort selection. AF, Atrial Fibrillation.
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pone-0057893-g001: Flowchart of study cohort selection. AF, Atrial Fibrillation.

Mentions: We identified a total of 145,623 patients from 1997–2009 discharged alive after first-time hospitalization for AF. Selection of the study cohort is depicted in Figure 1. Table 1 shows baseline characteristics for the new-onset AF cohort and the general population (n = 3,866,889). There were slightly more male patients (55.3%) with new-onset AF and they were older and had more comorbidity and concomitant medical treatment compared to the general population.


New-onset atrial fibrillation is a predictor of subsequent hyperthyroidism: a nationwide cohort study.

Selmer C, Hansen ML, Olesen JB, Mérie C, Lindhardsen J, Olsen AM, Madsen JC, Schmidt U, Faber J, Hansen PR, Pedersen OD, Torp-Pedersen C, Gislason GH - PLoS ONE (2013)

Flowchart of study cohort selection. AF, Atrial Fibrillation.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585274&req=5

pone-0057893-g001: Flowchart of study cohort selection. AF, Atrial Fibrillation.
Mentions: We identified a total of 145,623 patients from 1997–2009 discharged alive after first-time hospitalization for AF. Selection of the study cohort is depicted in Figure 1. Table 1 shows baseline characteristics for the new-onset AF cohort and the general population (n = 3,866,889). There were slightly more male patients (55.3%) with new-onset AF and they were older and had more comorbidity and concomitant medical treatment compared to the general population.

Bottom Line: Non-AF individuals from the general population served as reference.In both women and men we found a significantly increased risk of hyperthyroidism associated with new-onset AF compared to individuals in the general population.The highest risk was found in middle-aged men and was consistently increased throughout the 13-year period of observation.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark. cselmer@gmail.com

ABSTRACT

Aims: To examine the long-term risk of hyperthyroidism in patients admitted to hospital with new-onset AF. Hyperthyroidism is a well-known risk factor for atrial fibrillation (AF), but it is unknown whether new-onset AF predicts later-occurring hyperthyroidism.

Methods and results: All patients admitted with new-onset AF in Denmark from 1997-2009, and their present and subsequent use of anti-thyroid medication was identified by individual-level linkage of nationwide registries. Patients with previous thyroid diagnosis or thyroid medication use were excluded. Development of hyperthyroidism was assessed as initiation of methimazole or propylthiouracil up to a 13-year period. Risk of hyperthyroidism was analysed by Poisson regression models adjusted for important confounders such as amiodarone treatment. Non-AF individuals from the general population served as reference. A total of 145,623 patients with new-onset AF were included (mean age 66.4 years [SD ±13.2] and 55.3% males) of whom 3% (4,620 events; 62.2% women) developed hyperthyroidism in the post-hospitalization period compared to 1% (48,609 events; 82% women) in the general population (n = 3,866,889). In both women and men we found a significantly increased risk of hyperthyroidism associated with new-onset AF compared to individuals in the general population. The highest risk was found in middle-aged men and was consistently increased throughout the 13-year period of observation. The results were confirmed in a substudy analysis of 527,352 patients who had thyroid screening done.

Conclusion: New-onset AF seems to be a predictor of hyperthyroidism. Increased focus on subsequent risk of hyperthyroidism in patients with new-onset AF is warranted.

Show MeSH
Related in: MedlinePlus