Normal Thyroid Function and the Risk of Atrial Fibrillation: the Rotterdam Study

Chaker, Layal; Heeringa, Jan; Dehghan, Abbas; Medici, Marco; Visser, W Edward; Baumgartner, Christine; Hofman, Albert; Rodondi, Nicolas; Peeters, Robin P; Franco, Oscar H (2015). Normal Thyroid Function and the Risk of Atrial Fibrillation: the Rotterdam Study. Journal of clinical endocrinology and metabolism, 100(10), pp. 3718-3724. Endocrine Society 10.1210/jc.2015-2480

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CONTEXT Hyperthyroidism is an established risk factor for atrial fibrillation (AF), but information concerning the association with variations within the normal range of thyroid function and subgroups at risk is lacking. OBJECTIVE This study aimed to investigate the association between normal thyroid function and AF prospectively and explore potential differential risk patterns. DESIGN, SETTING, AND PARTICIPANTS From the Rotterdam Study we included 9166 participants ≥ 45 y with TSH and/or free T4 (FT4) measurements and AF assessment (1997-2012 median followup, 6.8 y), with 399 prevalent and 403 incident AF cases. MAIN OUTCOME MEASURES Outcome measures were 3-fold: 1) hazard ratios (HRs) for the risk of incident AF by Cox proportional-hazards models, 2) 10-year absolute risks taking competing risk of death into account, and 3) discrimination ability of adding FT4 to the CHARGE-AF simple model, an established prediction model for AF. RESULTS Higher FT4 levels were associated with higher risks of AF (HR 1.63, 95% confidence interval, 1.19-2.22), when comparing those in the highest quartile to those in lowest quartile. Absolute 10-year risks increased with higher FT4 in participants ≤ 65 y from 1-9% and from 6-12% in subjects ≥ 65 y. Discrimination of the prediction model improved when adding FT4 to the simple model (c-statistic, 0.722 vs 0.729; P = .039). TSH levels were not associated with AF. CONCLUSIONS There is an increased risk of AF with higher FT4 levels within the normal range, especially in younger subjects. Adding FT4 to the simple model slightly improved discrimination of risk prediction.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Baumgartner, Christine and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0021-972X

Publisher:

Endocrine Society

Language:

English

Submitter:

Jacques Donzé

Date Deposited:

29 Mar 2016 09:56

Last Modified:

01 Apr 2016 14:15

Publisher DOI:

10.1210/jc.2015-2480

PubMed ID:

26262438

BORIS DOI:

10.7892/boris.77304

URI:

https://boris.unibe.ch/id/eprint/77304

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