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Función de la tiroides y muerte cardíaca súbita: un estudio prospectivo de cohorte basado en la población

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
Resumen
Este resumen es generado por máquina.

Los niveles más altos de tiroxina libre (FT4), incluso dentro del rango normal, están relacionados con un mayor riesgo de muerte súbita cardíaca (SCD). Este hallazgo pone de relieve el FT4 como un potencial predictor de SCD en la población general.

Palabras clave:
el fallecimientomuerte súbita, cardíacaCiencias de la saludGlándula tiroides

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Área de la Ciencia:

  • Endocrinología
  • Cardiología
  • Epidemiología

Sus antecedentes:

  • La función tiroidea está relacionada con las enfermedades cardiovasculares.
  • Ningún estudio previo investigó la función tiroidea como factor de riesgo de muerte súbita cardíaca (SCD).

Objetivo del estudio:

  • Evaluar la asociación entre la función tiroidea y el riesgo de muerte súbita cardíaca (SCD) en una cohorte prospectiva basada en la población.

Principales métodos:

  • Estudio de cohorte prospectivo (Estudio de Rotterdam) en el que participaron 10.318 personas de ≥45 años.
  • Se midieron los niveles de hormona estimulante de la tiroides y de tiroxina libre (FT4).
  • Utilizó modelos de riesgos proporcionales de Cox y modelos de riesgo competidores para analizar el riesgo de ECS, ajustando los factores de riesgo cardiovascular.

Principales resultados:

  • Los niveles más altos de FT4 se asociaron con un mayor riesgo de ECS (HR 2,28 por 1 ng/ dl de FT4), incluso dentro del rango de función tiroidea normal.
  • El riesgo absoluto de ECS a 10 años aumentó del 1% al 4% en los participantes eutiroides con niveles crecientes de FT4.
  • Los análisis de sensibilidad confirmaron la solidez de estos resultados.

Conclusiones:

  • Los niveles elevados de FT4 están asociados con un mayor riesgo de muerte súbita cardíaca (SCD).
  • Esta asociación persiste incluso en individuos con función tiroidea normal, lo que sugiere que FT4 puede ser un factor de riesgo independiente para SCD.