Abstract
Subclinical hyperthyroidism (SH) has been reported associated with atrial fibrillation (AF), heart failure (HF) and coronary heart disease events, including mortality. An expert opinion indicates that AF is the possible link between SH and the other important cardiovascular (CV) manifestations. We analyzed the data of three recent studies including 60,883 subjects of whom 2,284 SH patients. In these subjects, the ratio between the AF events and each of the other above reported CV events varied from 0.14 to 0.4 in SH and from 0.2 to 2.4 in euthyroidism (ET). The general pattern of this ratio in 6 comparisons performed was not significantly higher for SH than ET. This data suggest that AF is not the major link between SH and the related CV manifestations. We suggest that a further link to be considered is the higher frequency of the early atherosclerosis manifestations such as carotid intima media thickness or carotid integrated back scatter, observed in SH. This atherogenic effect of SH can affect the occurrence of all the above clinical CV manifestations.
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Collet TH, Gusskloo J, Bauer DC, den Elzen WPJ, Coppola AR, Balmer P, Iervasi G, Asvold BO, Sgarbi JA, Volzke H, Gencer B, Maciel RMB, Molinaro S, Bremner A, Luben RN, Maisonneuve P, Cornuz J, Newman AB, Khaw KT, Westendorp RGJ, Franklyn JA, Vittinghoff E, Walsh JP, Rodondi N (2012) Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Arch Intern Med 172(10):799–809
Biondi B, Kahaly GJ (2010) Cardiovascular involvement in patients with different causes of hyperthyroidism. Nat Rev Endocrinol 6:431–443
Biondi B (2012) How could we improve the increased cardiovascular mortality in patients with overt and subclinical hyperthyroidism? Eur J Endocrinol 167:295–299
Reverter JL, Colomè E (2010) Potential risks of the adverse effects of thyrotropin suppression in differentiated thyroid carcinoma. Endocrinol Nutr 58(2):75–83
Biondi B (2012) Natural history, diagnosis and management of subclinical thyroid dysfunction. Best Pract Res Clin Endocrinol Metab 26:431–446
Volzke H, Robinson DM, Schminke U, Ludemann J, Retting R, Felix SB, Kessler C, John U, Meng W (2004) Thyroid function and carotid wall thickness. J Clin Endocrinol Metab 89(5):2145–2149
Nanchen D, Gusselkoo J, Westendorp RGJ, Stott DJ, Jukema JW, Trompet S, Ford I, Welsh P, Sattar N, Macfarlane PW, Mooijaart SP, Rodondi N, de Craen AJM, on beahalf of the PROSPEN Group (2012) Subclinical thyroid dysfunction and the risk, of heart failure in older persons at high cardiovascular risk. J Clin Endocrinol Metab 97(3):852–861
Schultz M, Kistorp C, Raymond I, Dimsits J, Tuxen C, Hildebrand P, Faber J (2011) Cardiovascular events in thyroid disease: a population based, prospective study. Horm Metab Res 43:653–659
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Carpi, A., Cini, G., Russo, M. et al. Subclinical hyperthyroidism and cardiovascular manifestations: a reevaluation of the association. Intern Emerg Med 8 (Suppl 1), 75–77 (2013). https://doi.org/10.1007/s11739-013-0913-2
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DOI: https://doi.org/10.1007/s11739-013-0913-2