Normal Thyroid Function and the Risk of Atrial Fibrillation: the Rotterdam Study.
- Chaker L Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- Heeringa J Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- Dehghan A Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- Medici M Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- Visser WE Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- Baumgartner C Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- Hofman A Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- Rodondi N Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- Peeters RP Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- Franco OH Rotterdam Thyroid Center (L.C., M.M., W.E.V., R.P.P.), Department of Internal Medicine (L.C., M.M., W.E.V., R.P.P.), and Department of Epidemiology (L.C., J.H., A.D., A.H., O.H.F.), Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands; and Department of General Internal Medicine (C.B., N.R.), Inselspital, University Hospital of Bern, 3010 Bern, Switzerland.
- 2015-08-12
Published in:
- The Journal of clinical endocrinology and metabolism. - 2015
Aged
Aged, 80 and over
Atrial Fibrillation
Female
Humans
Incidence
Male
Middle Aged
Prevalence
Risk
Thyroid Function Tests
Thyroid Gland
Thyrotropin
Thyroxine
English
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.
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.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1210/jc.2015-2480
- PMID 26262438
- Persistent URL
- https://folia.unifr.ch/global/documents/60185
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