J Clin Endocrinol Metab. 2023 Aug 11:dgad448. doi: 10.1210/clinem/dgad448. Online ahead of print.
ABSTRACT
BACKGROUND: Atrial fibrillation (AF) has been linked to increased hyperthyroidism risk, but contributing factors are unclear.
METHODS: This retrospective cohort study was conducted in a tertiary medical institution and included patients aged 18 years or older with AF but without hyperthyroidism at diagnosis. The endpoint was defined as newly diagnosed hyperthyroidism during follow-up.
RESULTS: The study cohort included 8,552 participants. Patients who developed new hyperthyroidism were younger and had a higher proportion of females. They had fewer comorbidities, including diabetes (26% vs 29%, p = 0.121), hypertension (51% vs 58%, p < 0.001), coronary artery disease (17% vs 25%, p < 0.001), stroke (16% vs 22%, p < 0.001), and end-stage renal disease (ESRD) (6% vs 10%, p = 0.001). The CHADS2 score was lower in patients with hyperthyroidism (1.74 vs 2.05, p = 0.031), but there was no statistically significant difference in the CHA2DS2-VAsc and HAS-BLED score. Cox regression analysis identified younger age, female gender, history of congestive heart failure, hypertension, diabetes, non-ESRD status, and lower CHADS2 score but not CHA2DS2-VASc as independent predictors of incident hyperthyroidism during follow-up. We also propose a novel, simple risk stratification score (SAD HEC2 score) with excellent predictive power for incident hyperthyroidism during follow-up.
CONCLUSIONS: Our results provide insight into clinical risk factors for the development of hyperthyroidism in AF patients, as identified by the novel SAD HEC2 score. AF appears to be a common precursor of hyperthyroidism.
PMID:37565329 | DOI:10.1210/clinem/dgad448
