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Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts.
Tuesday,2013-10-01 10:13 America/Los_Angeles — poolea2
| Title | Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. |
| Publication Type | Journal Article |
| Year of Publication | 2012 |
| Authors | Gencer, B, Collet, T-H, Virgini, V, Bauer, DC, Gussekloo, J, Cappola, AR, Nanchen, D, Elzen, WPJ den, Balmer, P, Luben, RN, Iacoviello, M, Triggiani, V, Cornuz, J, Newman, AB, Khaw, K-T, J Jukema, W, Westendorp, RGJ, Vittinghoff, E, Aujesky, D, Rodondi, N |
| Corporate/Institutional Authors | Thyroid Studies Collaboration, |
| Journal | Circulation |
| Volume | 126 |
| Issue | 9 |
| Pagination | 1040-9 |
| Date Published | 2012 Aug 28 |
| ISSN | 1524-4539 |
| Keywords | Adult, Aged, Aged, 80 and over, Comorbidity, Female, Follow-Up Studies, Heart Failure, Humans, Hypothyroidism, Male, Middle Aged, Prospective Studies, Risk, Risk Factors, Sensitivity and Specificity, Thyrotropin, Thyroxine |
| Abstract | <p><b>BACKGROUND: </b>American College of Cardiology/American Heart Association guidelines for the diagnosis and management of heart failure recommend investigating exacerbating conditions such as thyroid dysfunction, but without specifying the impact of different thyroid-stimulation hormone (TSH) levels. Limited prospective data exist on the association between subclinical thyroid dysfunction and heart failure events.</p><p><b>METHODS AND RESULTS: </b>We performed a pooled analysis of individual participant data using all available prospective cohorts with thyroid function tests and subsequent follow-up of heart failure events. Individual data on 25 390 participants with 216 248 person-years of follow-up were supplied from 6 prospective cohorts in the United States and Europe. Euthyroidism was defined as TSH of 0.45 to 4.49 mIU/L, subclinical hypothyroidism as TSH of 4.5 to 19.9 mIU/L, and subclinical hyperthyroidism as TSH <0.45 mIU/L, the last two with normal free thyroxine levels. Among 25 390 participants, 2068 (8.1%) had subclinical hypothyroidism and 648 (2.6%) had subclinical hyperthyroidism. In age- and sex-adjusted analyses, risks of heart failure events were increased with both higher and lower TSH levels (P for quadratic pattern <0.01); the hazard ratio was 1.01 (95% confidence interval, 0.81-1.26) for TSH of 4.5 to 6.9 mIU/L, 1.65 (95% confidence interval, 0.84-3.23) for TSH of 7.0 to 9.9 mIU/L, 1.86 (95% confidence interval, 1.27-2.72) for TSH of 10.0 to 19.9 mIU/L (P for trend <0.01) and 1.31 (95% confidence interval, 0.88-1.95) for TSH of 0.10 to 0.44 mIU/L and 1.94 (95% confidence interval, 1.01-3.72) for TSH <0.10 mIU/L (P for trend=0.047). Risks remained similar after adjustment for cardiovascular risk factors.</p><p><b>CONCLUSION: </b>Risks of heart failure events were increased with both higher and lower TSH levels, particularly for TSH ≥10 and <0.10 mIU/L.</p> |
| DOI | 10.1161/CIRCULATIONAHA.112.096024 |
| Alternate Journal | Circulation |
| PubMed ID | 22821943 |
| PubMed Central ID | PMC3884576 |
| Grant List | P30 AG024827 / AG / NIA NIH HHS / United States R01 AG-15928 / AG / NIA NIH HHS / United States R01-AG028050 / AG / NIA NIH HHS / United States N01-HC-80007 / HC / NHLBI NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States K24 AR051895 / AR / NIAMS NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-AG-62101 / AG / NIA NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States R01-NR012459 / NR / NINR NIH HHS / United States / / Medical Research Council / United Kingdom P30-AG-024827 / AG / NIA NIH HHS / United States AG-032317 / AG / NIA NIH HHS / United States R01-HL-075366 / HL / NHLBI NIH HHS / United States G1000143 / / Medical Research Council / United Kingdom N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States R01 NR012459 / NR / NINR NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States / / Cancer Research UK / United Kingdom N01-AG-62106 / AG / NIA NIH HHS / United States G0401527 / / Medical Research Council / United Kingdom N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States R01 AG-20098 / AG / NIA NIH HHS / United States R01 AG028050 / AG / NIA NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States R01 AG032317 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-AG-62103 / AG / NIA NIH HHS / United States AG-023629 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States |