Subclinical Hyperthyroidism and Risk of Cardiovascular and All-cause Mortality

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 414-431-HPT Axis Biology
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-426
Christian Selmer*1, Jonas Bjerring Olesen2, Jesper Clausager Madsen3, Jens Faber4, Peter Riis Hansen2, Ole Dyg Pedersen5, Morten Lock Hansen2, Christian Torp-Pedersen6 and Gunnar Hilmar Gislason2
1Gentofte University Hospital, Hellerup, Denmark, 2Gentofte University Hospital, 3Copenhagen General Practitioners Laboratory, 4Herlev University Hospital, 5Roskilde University Hospital, 6Aalborg University, Aalborg
Background: It is still discussed if subclinical hyperthyroidism and “high-normal” thyroid function are risk-factors for cardiovascular mortality.

Objectives: To examine the risk of cardiovascular and all-cause mortality in relation to subclinical hyperthyroidism.

Methods: Patients consulting their general practitioner from 2000–2009 in Copenhagen, Denmark, who underwent thyroid blood tests, were identified by individual-level linkage of nationwide registries. Patients with a history of thyroid disease or related medication were excluded. Risk of cardiovascular mortality was analyzed using Kaplan-Meier curves and Poisson regression models were applied to estimate Incidence Rate Ratios (IRR).

Results: Of 574,595 included individuals (mean age 48.7 years [SD ±18.3]; 39.1% males) 550,927 (95.9%) were euthyroid, 1,603 (0.3%) had overt hypothyroidism, 11,834 (2.1%) subclinical hypothyroidism, 3,967 (0.7%) overt hyperthyroidism and 6,264 (1.1%) subclinical hyperthyroidism. Increased risk of cardiovascular mortality was found in two levels of subclinical hyperthyroidism (TSH <0.1, 0.1–0.2 mU/L and normal free thyroixine): IRR 1.24 [95% CI: 1.09–1.41], IRR 1.21 [1.09–1.34] and in “high-normal” levels of euthyroidism (TSH 0.2–0.4 mU/L): IRR 1.21 [1.13–1.29].

Conclusions: Subclinical hyperthyroidism and “high-normal” thyroid function are significant risk-factors for cardiovascular and all-cause mortality.

Nothing to Disclose: CS, JBO, JCM, JF, PRH, ODP, MLH, CT, GHG

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm