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Association Between Autoimmune Thyroiditis and Cervical Artery Dissection: A Retrospective Cohort Study

Robert J Trager1,2,3, Pratheek S Makineni4, Debbie S Wright5,6

  • 1Connor Whole Health University Hospitals Cleveland Medical Center Cleveland Ohio USA.

Health Science Reports
|April 23, 2026
PubMed

Insights

Autoimmune thyroiditis (AT) is linked to a higher risk of cervical artery dissection (CeAD). This study found AT patients had a 58% increased risk of CeAD within three years, highlighting a significant association.

Area of Science:

  • Endocrinology
  • Neurology
  • Vascular Medicine

Background:

  • Limited evidence suggests a potential link between autoimmune thyroiditis (AT) and cervical artery dissection (CeAD).
  • Further investigation is needed to confirm AT as a risk factor for CeAD.

Purpose of the Study:

  • To test the hypothesis that AT is associated with an increased risk of CeAD.
  • To compare the incidence of CeAD in patients with AT versus matched euthyroid controls within three years of diagnosis.

Main Methods:

  • A de-identified US claims database (TriNetX) was used to identify adult patients with newly diagnosed AT and matched euthyroid controls from 2014-2024.
  • Propensity score matching controlled for CeAD-associated variables.
  • The primary outcome was the risk ratio (RR) for CeAD within three years, with secondary outcomes including vertebral/carotid artery dissection and stroke.

Main Results:

  • The AT cohort (143,831 patients) showed a significantly greater incidence and risk of CeAD compared to controls (0.040% vs. 0.025%; RR=1.58; p=0.029).
  • A significant increase in carotid artery dissection (RR=2.33; p=0.011) and stroke (RR=1.67; p<0.001) was observed in the AT group.
  • The cumulative incidence of CeAD demonstrated a time-dependent increase in AT patients relative to controls.

Conclusions:

  • Autoimmune thyroiditis is identified as a risk factor for cervical artery dissection.
  • Further research is warranted to explore mediating factors such as medications, hormone levels, and antibody status in the AT-CeAD association.
Abstract

Keywords:
autoimmune diseasescardiovascular diseasescerebrovascular disordersinternal carotid artery dissectionthyroid diseasesvertebral artery dissection

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