title: Subclinical hyperthyroidism and cardiovascular manifestations: a reevaluation of the association.
abstract: Subclinical hyperthyroidism (SH) has been reported associated with atrial fibrillation (AF), heart failure (HF) and coronary heart disease events, including mortality. An expert opinion indicates that AF is the possible link between SH and the other important cardiovascular (CV) manifestations. We analyzed the data of three recent studies including 60,883 subjects of whom 2,284 SH patients. In these subjects, the ratio between the AF events and each of the other above reported CV events varied from 0.14 to 0.4 in SH and from 0.2 to 2.4 in euthyroidism (ET). The general pattern of this ratio in 6 comparisons performed was not significantly higher for SH than ET. This data suggest that AF is not the major link between SH and the related CV manifestations. We suggest that a further link to be considered is the higher frequency of the early atherosclerosis manifestations such as carotid intima media thickness or carotid integrated back scatter, observed in SH. This atherogenic effect of SH can affect the occurrence of all the above clinical CV manifestations.
authors: Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 6-7, 56126, Pisa, Italy. angelo.carpi@med.unipi.it
authors: Angelo
authors: A
authors: Carpi
authors: Giuseppe
authors: G
authors: Cini
authors: Matteo
authors: M
authors: Russo
authors: Alessandro
authors: A
authors: Antonelli
authors: Carlo
authors: C
authors: Gaudio
authors: Fabio
authors: F
authors: Galetta
authors: Ferdinando
authors: F
authors: Franzoni
authors: Giuseppe
authors: G
authors: Rossi
mesh_terms: D001281:Atrial Fibrillation / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000209:etiology; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications*