Titre
Thyroid antibody status, subclinical hypothyroidism, and the risk of coronary heart disease: an individual participant data analysis.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Collet, T.H.
Auteure/Auteur
Bauer, D.C.
Auteure/Auteur
Cappola, A.R.
Auteure/Auteur
Asvold, B.O.
Auteure/Auteur
Weiler, S.
Auteure/Auteur
Vittinghoff, E.
Auteure/Auteur
Gussekloo, J.
Auteure/Auteur
Bremner, A.
Auteure/Auteur
den Elzen, W.P.
Auteure/Auteur
Maciel, R.M.
Auteure/Auteur
Vanderpump, M.P.
Auteure/Auteur
Cornuz, J.
Auteure/Auteur
Dörr, M.
Auteure/Auteur
Wallaschofski, H.
Auteure/Auteur
Newman, A.B.
Auteure/Auteur
Sgarbi, J.A.
Auteure/Auteur
Razvi, S.
Auteure/Auteur
Völzke, H.
Auteure/Auteur
Walsh, J.P.
Auteure/Auteur
Aujesky, D.
Auteure/Auteur
Rodondi, N.
Auteure/Auteur
Groupes de travail
Thyroid Studies Collaboration
Liens vers les personnes
Liens vers les unités
ISSN
1945-7197
Statut éditorial
Publié
Date de publication
2014
Volume
99
Numéro
9
Première page
3353
Dernière page/numéro d’article
3362
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Résumé
CONTEXT: Subclinical hypothyroidism has been associated with increased risk of coronary heart disease (CHD), particularly with thyrotropin levels of 10.0 mIU/L or greater. The measurement of thyroid antibodies helps predict the progression to overt hypothyroidism, but it is unclear whether thyroid autoimmunity independently affects CHD risk.
OBJECTIVE: The objective of the study was to compare the CHD risk of subclinical hypothyroidism with and without thyroid peroxidase antibodies (TPOAbs).
DATA SOURCES AND STUDY SELECTION: A MEDLINE and EMBASE search from 1950 to 2011 was conducted for prospective cohorts, reporting baseline thyroid function, antibodies, and CHD outcomes.
DATA EXTRACTION: Individual data of 38 274 participants from six cohorts for CHD mortality followed up for 460 333 person-years and 33 394 participants from four cohorts for CHD events.
DATA SYNTHESIS: Among 38 274 adults (median age 55 y, 63% women), 1691 (4.4%) had subclinical hypothyroidism, of whom 775 (45.8%) had positive TPOAbs. During follow-up, 1436 participants died of CHD and 3285 had CHD events. Compared with euthyroid individuals, age- and gender-adjusted risks of CHD mortality in subclinical hypothyroidism were similar among individuals with and without TPOAbs [hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.87-1.53 vs HR 1.26, CI 1.01-1.58, P for interaction = .62], as were risks of CHD events (HR 1.16, CI 0.87-1.56 vs HR 1.26, CI 1.02-1.56, P for interaction = .65). Risks of CHD mortality and events increased with higher thyrotropin, but within each stratum, risks did not differ by TPOAb status.
CONCLUSIONS: CHD risk associated with subclinical hypothyroidism did not differ by TPOAb status, suggesting that biomarkers of thyroid autoimmunity do not add independent prognostic information for CHD outcomes.
OBJECTIVE: The objective of the study was to compare the CHD risk of subclinical hypothyroidism with and without thyroid peroxidase antibodies (TPOAbs).
DATA SOURCES AND STUDY SELECTION: A MEDLINE and EMBASE search from 1950 to 2011 was conducted for prospective cohorts, reporting baseline thyroid function, antibodies, and CHD outcomes.
DATA EXTRACTION: Individual data of 38 274 participants from six cohorts for CHD mortality followed up for 460 333 person-years and 33 394 participants from four cohorts for CHD events.
DATA SYNTHESIS: Among 38 274 adults (median age 55 y, 63% women), 1691 (4.4%) had subclinical hypothyroidism, of whom 775 (45.8%) had positive TPOAbs. During follow-up, 1436 participants died of CHD and 3285 had CHD events. Compared with euthyroid individuals, age- and gender-adjusted risks of CHD mortality in subclinical hypothyroidism were similar among individuals with and without TPOAbs [hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.87-1.53 vs HR 1.26, CI 1.01-1.58, P for interaction = .62], as were risks of CHD events (HR 1.16, CI 0.87-1.56 vs HR 1.26, CI 1.02-1.56, P for interaction = .65). Risks of CHD mortality and events increased with higher thyrotropin, but within each stratum, risks did not differ by TPOAb status.
CONCLUSIONS: CHD risk associated with subclinical hypothyroidism did not differ by TPOAb status, suggesting that biomarkers of thyroid autoimmunity do not add independent prognostic information for CHD outcomes.
PID Serval
serval:BIB_F6F2961AC473
PMID
Open Access
Oui
Date de création
2014-10-23T17:53:16.718Z
Date de création dans IRIS
2025-05-21T06:43:08Z
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5_24915118_Postprint.pdf
Version du manuscrit
postprint
Taille
737.49 KB
Format
Adobe PDF
PID Serval
serval:BIB_F6F2961AC473.P001
URN
urn:nbn:ch:serval-BIB_F6F2961AC4735
Somme de contrôle
(MD5):1bee8821f1f9c58abd2bdf7e9ee89006