1. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts
- Author
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Gencer, B., Collet, T.H., Virgini, V., Bauer, D.C., Gussekloo, J., Cappola, A.R., Nanchen, D., Elzen, W.P.J. den, Balmer, P., Luben, R.N., Iacoviello, M., Triggiani, V., Cornuz, J., Newman, A.B., Khaw, K.T., Jukema, J.W., Westendorp, R.G.J., Vittinghoff, E., Aujesky, D., Rodondi, N., Thyroid Studies Collaboration, and Thyroid Studies Collaboration
- Subjects
Male ,endocrine system diseases ,Thyrotropin ,heart failure ,Comorbidity ,030204 cardiovascular system & hematology ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,thyroid ,0302 clinical medicine ,cohort studies ,Risk Factors ,80 and over ,Prospective Studies ,Prospective cohort study ,Subclinical infection ,Aged, 80 and over ,medicine.diagnostic_test ,Thyroid ,Middle Aged ,medicine.anatomical_structure ,Heart Disease ,Public Health and Health Services ,Female ,epidemiology ,Cardiology and Cardiovascular Medicine ,hormones, hormone substitutes, and hormone antagonists ,Cohort study ,Risk ,Adult ,endocrine system ,medicine.medical_specialty ,Management of heart failure ,Clinical Sciences ,030209 endocrinology & metabolism ,Aged ,Follow-Up Studies ,Heart Failure/epidemiology ,Humans ,Hypothyroidism/blood ,Hypothyroidism/epidemiology ,Sensitivity and Specificity ,Thyrotropin/blood ,Thyroxine/blood ,Thyroid function tests ,Article ,03 medical and health sciences ,Hypothyroidism ,Clinical Research ,Physiology (medical) ,Internal medicine ,medicine ,Metabolic and endocrine ,business.industry ,Thyroid Studies Collaboration ,medicine.disease ,meta-analysis ,Thyroxine ,Endocrinology ,Cardiovascular System & Hematology ,Heart failure ,business - Abstract
Background— 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. Methods and Results— 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 P for quadratic pattern P for trend P for trend=0.047). Risks remained similar after adjustment for cardiovascular risk factors. Conclusion— Risks of heart failure events were increased with both higher and lower TSH levels, particularly for TSH ≥10 and
- Published
- 2012