Related Experiment Video
Updated: Sep 30, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Yearly Incidence of Stroke and Bleeding in Atrial Fibrillation with Concomitant Hyperthyroidism: A National Discharge
Juqian Zhang1, Arnaud Bisson2, Grégoire Fauchier3
1Liverpool Centre for Cardiovascular Science, Liverpool Heart & Chest Hospital, University of Liverpool, Liverpool L7 8TX, UK.
Insights
Hyperthyroidism increases the risk of stroke in atrial fibrillation (AF) patients, especially within the first year of diagnosis. Bleeding risk was lower in AF patients with hyperthyroidism.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Atrial fibrillation (AF) is a significant stroke risk factor.
- Hyperthyroidism is known to be associated with AF.
- The combined impact of hyperthyroidism and AF on stroke and bleeding risk requires further investigation.
Purpose of the Study:
- To determine the yearly incidence of ischemic stroke and bleeding in AF patients with and without hyperthyroidism.
- To assess hyperthyroidism as an independent risk factor for stroke in AF patients.
- To evaluate the predictive performance of CHA2DS2-VASc and HAS-BLED scores in this population.
Main Methods:
- Retrospective analysis of the French National Hospital Discharge Database (2010-2019).
- Inclusion of 2,421,087 AF patients, with 32,400 having concomitant hyperthyroidism.
- Comparison of incidence rates and risk factor associations using Cox regression.
Main Results:
- Yearly ischemic stroke incidence was 2.6% in AF patients with hyperthyroidism vs. 2.3% without.
- Hyperthyroidism was an independent risk factor for ischemic stroke (aHR: 1.133), particularly in the first year (aHR: 1.203).
- Major bleeding incidence was lower in the hyperthyroid AF group (5.1%/year vs. 5.4%/year).
Conclusions:
- Hyperthyroidism is an independent risk factor for ischemic stroke in AF patients, especially within the first year post-diagnosis.
- Risk stratification scores (CHA2DS2-VASc, HAS-BLED) showed similar predictive value in both groups.
- Findings highlight the importance of managing hyperthyroidism in AF patients to mitigate stroke risk.
Abstract:
Background: Hyperthyroidism is associated with atrial fibrillation (AF), and the latter is a major risk factor for stroke. Aim: We aimed to investigate the yearly incidence of stroke and bleeding in AF patients with and without concomitant hyperthyroidism from the French National Hospital Discharge Database. Methods: Admissions with AF between January 2010 and December 2019 were retrospectively identified and retrieved from the French national database. Incidence rates of ischaemic stroke and bleeding were compared in AF patients with and without concomitant hyperthyroidism. The associations of risk factors with ischaemic stroke were assessed by Cox regression. Results: Overall 2,421,087 AF patients, among whom 32,400 had concomitant hyperthyroidism were included in the study. During the follow-up (mean: 2.0 years, standard deviation SD: 2.2 years), the yearly incidence of ischaemic stroke was noted to be 2.6 (95% confidence interval CI: 2.5−2.8) in AF patients with concomitant hyperthyroidism, and 2.3 (95%CI: 2.3−2.4) in non-thyroid AF patients. Hyperthyroidism was noted as an independent risk factor for ischaemic stroke (adjusted hazard ratio aHR: 1.133, 95%CI: 1.080−1.189) overall, particularly within the first year of hyperthyroidism diagnosis (aHR 1.203, 95%CI 1.120−1.291), however, the association became non-significant in subsequent years (aHR 1.047, 95%CI 0.980−1.118). Major bleeding incidence was lower in the hyperthyroid AF group in comparison to the non-thyroid AF group (incidence ratio: 5.1 vs. 5.4%/year, p < 0.001). The predictive value of CHA2DS2VASc and HAS-BLED scores for ischaemic stroke and bleeding events, respectively, did not differ significantly between AF patients with or without concomitant hyperthyroidism. Conclusions: Hyperthyroidism seems to be an independent risk factor of ischaemic stroke in AF patients, particularly within the first year of hyperthyroidism diagnosis.
More Related Videos
Related Concept Videos
01:28Dysrhythmias II: Classification of Tachyarrhythmias
01:24Disorders of Hemostasis
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:29Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
01:29Dysrhythmias III: Characteristics of Dysrhythmias
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies