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Thyroid Function and Sudden Cardiac Death: A Prospective Population-Based Cohort Study.

Layal Chaker1, Marten E van den Berg1, Maartje N Niemeijer1

  • 1From Rotterdam Thyroid Center (L.C., R.P.P.), Department of Internal Medicine (L.C., B.H.C.S., R.P.P.), and Department of Epidemiology (L.C., M.E.v.d.B., M.N.N., O.H.F., A.D., A.H., M.E., B.H.C.S., R.P.P.), Erasmus University Medical Center; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Departments of Medical Informatics (P.R.R.) and Cardiology (J.W.D.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Inspectorate of Health Care, Utrecht, The Netherlands (B.H.C.S.).

Circulation
|September 8, 2016
PubMed
Summary
This summary is machine-generated.

Higher free thyroxine (FT4) levels, even within the normal range, are linked to an increased risk of sudden cardiac death (SCD). This finding highlights FT4 as a potential predictor for SCD in the general population.

Keywords:
deathdeath, sudden, cardiacepidemiologythyroid gland

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Area of Science:

  • Endocrinology
  • Cardiology
  • Epidemiology

Background:

  • Thyroid function is linked to cardiovascular disease.
  • No prior studies investigated thyroid function as a risk factor for sudden cardiac death (SCD).

Purpose of the Study:

  • To assess the association between thyroid function and the risk of sudden cardiac death (SCD) in a prospective, population-based cohort.

Main Methods:

  • Prospective cohort study (Rotterdam Study) including 10,318 participants aged ≥45 years.
  • Measured thyroid-stimulating hormone and free thyroxine (FT4) levels.
  • Used Cox proportional-hazards models and competing risk models to analyze SCD risk, adjusting for cardiovascular risk factors.

Main Results:

  • Higher FT4 levels were associated with increased SCD risk (HR 2.28 per 1 ng/dL FT4), even within the normal thyroid function range.
  • The absolute 10-year risk of SCD increased from 1% to 4% in euthyroid participants with rising FT4 levels.
  • Sensitivity analyses confirmed the robustness of these findings.

Conclusions:

  • Elevated FT4 levels are associated with a higher risk of sudden cardiac death (SCD).
  • This association persists even in individuals with normal thyroid function, suggesting FT4 may be an independent risk factor for SCD.