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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

Development of hyperthyroidism in patients with new-onset atrial fibrillation following hospital discharge and in the general population from 1997–2009.Incidence rates per 100,000 person-years (95% confidence intervals). AF, Atrial Fibrillation; CI, Confidence Interval.
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pone-0057893-g003: Development of hyperthyroidism in patients with new-onset atrial fibrillation following hospital discharge and in the general population from 1997–2009.Incidence rates per 100,000 person-years (95% confidence intervals). AF, Atrial Fibrillation; CI, Confidence Interval.

Mentions: Incidence rates for developing hyperthyroidism for the general population and the cohort with new-onset AF are shown in Table 2 and Figure 2. The incidence rates in the general population were on average around 100 per 100,000 person-years as previously described in Danish studies[17], with the highest rates among women and the elderly. The peak rate of incident hyperthyroidism in the new-onset AF cohort was found among women 51–60 years of age, whereas the men had a markedly lower incidence throughout the age groups. The incidence rate of hyperthyroidism was continuously increased following new-onset AF compared to the average rate in the general population (Figure 3). Notably, there was a very high incidence-rate during the initial period after new-onset AF for both women and men.


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)

Development of hyperthyroidism in patients with new-onset atrial fibrillation following hospital discharge and in the general population from 1997–2009.Incidence rates per 100,000 person-years (95% confidence intervals). AF, Atrial Fibrillation; CI, Confidence Interval.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0057893-g003: Development of hyperthyroidism in patients with new-onset atrial fibrillation following hospital discharge and in the general population from 1997–2009.Incidence rates per 100,000 person-years (95% confidence intervals). AF, Atrial Fibrillation; CI, Confidence Interval.
Mentions: Incidence rates for developing hyperthyroidism for the general population and the cohort with new-onset AF are shown in Table 2 and Figure 2. The incidence rates in the general population were on average around 100 per 100,000 person-years as previously described in Danish studies[17], with the highest rates among women and the elderly. The peak rate of incident hyperthyroidism in the new-onset AF cohort was found among women 51–60 years of age, whereas the men had a markedly lower incidence throughout the age groups. The incidence rate of hyperthyroidism was continuously increased following new-onset AF compared to the average rate in the general population (Figure 3). Notably, there was a very high incidence-rate during the initial period after new-onset AF for both women and men.

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