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Updated: Aug 6, 2025
Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
Published on: June 9, 2023
Association between thyroid cancer and cardiovascular disease: A meta-analysis
Wen-Hsuan Tsai1, Yi-Hong Zeng1,2, Chun-Chuan Lee1,2
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Insights
Thyroid cancer increases the risk of cerebrovascular disease and atrial fibrillation. Cardiovascular disease mortality was not significantly affected, and radioactive iodine treatment showed no impact on cardiovascular health.
Area of Science:
- Cardiology
- Endocrinology
- Oncology
Background:
- Thyroid cancer is a growing global health concern.
- Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide.
- The relationship between thyroid cancer and CVDs requires further investigation.
Purpose of the Study:
- To investigate the association between thyroid cancer and major cardiovascular diseases.
- To assess the impact of thyroid cancer on cardiovascular disease mortality.
- To evaluate the effect of radioactive iodine treatment on cardiovascular outcomes in thyroid cancer patients.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Embase, and Cochrane Library databases up to September 22, 2022.
- Meta-analysis of 15 studies including 771,220 patients who underwent thyroidectomy.
- Primary outcomes included incidence of coronary artery disease, cerebrovascular disease, atrial fibrillation, and CVD mortality.
Main Results:
- Thyroid cancer significantly increased the risk of cerebrovascular disease (RR 1.15) and atrial fibrillation (RR 1.59).
- A significant increase in coronary artery disease risk was observed (RR 1.12).
- No significant association was found between thyroid cancer and cardiovascular disease mortality (RR 0.93). Radioactive iodine treatment had a neutral effect on CVD.
Conclusions:
- Thyroid cancer is linked to a higher risk of cerebrovascular disease and atrial fibrillation.
- Radioactive iodine treatment did not alter the hazard risk for cardiovascular diseases.
- Individualized thyroid cancer treatment strategies should consider potential cardiovascular implications.
Objective:
To determine the association between thyroid cancer and coronary artery disease, atrial fibrillation, cerebrovascular disease, and cardiovascular disease mortality.
Methods:
The PubMed, Embase, and Cochrane Library databases were searched for eligible studies from inception to September 22, 2022. Keywords included "thyroid cancer", "atrial fibrillation", "coronary artery disease", "cerebrovascular disease", and "mortality". Primary outcomes included the incidence of coronary artery disease, cerebrovascular disease, atrial fibrillation, and cardiovascular disease mortality among patients with thyroid cancer. Secondary outcomes included cardiovascular disease events among those with thyroid cancer that received or did not receive radioactive iodine or lenvatinib. Estimates were pooled using fixed- and random-effects meta-analysis.
Results:
A total of 771,220 patients who underwent thyroidectomy in 15 studies were included. Risk for cerebrovascular disease (risk ratio [RR] 1.15 [95% confidence interval (CI) 1.10-1.21]) and atrial fibrillation [RR 1.59 (95% CI: 1.45-1.73)] were significantly increased. Risk for coronary artery disease was significantly increased [RR 1.12 (95% CI: 1.08-1.17)] in the common effect model. Cardiovascular disease mortality associated with thyroid cancer was not significant [RR 0.93 (95% CI: 0.59-1.45)]. Radioactive iodine had a neutral effect on cardiovascular disease [RR 1.00 (95% CI: 0.87-1.16)], and there was no beneficial nor harmful effect among different RAI doses.
Conclusions:
Thyroid cancer was significantly associated with a higher risk for cerebrovascular disease and atrial fibrillation; however, the hazard risk was not different between patients with and without radioactive iodine treatment. Thyroid cancer treatment should be individualized considering the potential harms and benefits to cardiovascular health.
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