title: Hashimoto's thyroiditis, risk of coronary heart disease, and L-thyroxine treatment: a nationwide cohort study.
abstract: OBJECTIVE
  Our objective was to investigate the risk of coronary heart disease (CHD) in patients with Hashimoto's thyroiditis (HT).
  
  
  METHODS
  The Taiwan National Health Insurance Research Database was used to conduct a retrospective cohort analysis. The cohort study consisted of 1165 newly diagnosed HT patients and 4660 matched controls (non-HT patients) from 2000 to 2010. The median follow-up time was 5.46 years. The risk of developing CHD for HT patients was measured using the Cox proportional hazards model.
  
  
  RESULTS
  The risk of developing CHD in HT patients was increased compared with the non-HT controls, with an adjusted hazard ratio (HR) of 1.44 (95% confidence interval [CI] = 1.05-1.99). The risk was significant in women but not in men, and restricted to subjects younger than 49 years. HT remained an independent risk factor after adjusting for comorbidities; however, combining with hypertension or hyperlipidemia further increased the risk of CHD (adjusted HR = 2.06, 95% CI = 1.46-2.92; and adjusted HR = 1.83, 95% CI = 1.31-2.55, respectively). Furthermore, HT without T4 treatment and HT with treatment for less than 1 year were associated with higher risk of CHD (adjusted HR = 1.55, 95% CI = 0.98-2.46; and adjusted HR = 2.42, 95% CI = 1.43-3.97, respectively). The risk of CHD decreased after treatment with T4 for more than 1 year and did not differ from the non-HT cohort (adjusted HR = 0.84, 95% CI = 0.0.47-1.52).
  
  
  CONCLUSIONS
  Patients with HT, are at higher risk of developing CHD compared with the general population. Treatment with T4 reduces the risk of CHD.
authors.affiliation: Department of Neurology (W.-H.C., J.-H.Y.) and Department of Nuclear Medicine and PET Center (Y.-K.C.), Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan; School of Medicine (Y.-K.C., J.-H.Y.), Fu-Jen Catholic University, New Taipei City 242, Taiwan; and Management Office for Health Data (C.-L.L.); Graduate Institute of Clinical Medicine Science and School of Medicine (C.-H.K.), College of Medicine (C.-L.L.); and Department of Nuclear Medicine and PET Center (C.-H.K.), China Medical University Hospital, Taichung 404, Taiwan.
authors.forename: Wei-Hung
authors.initials: WH
authors.lastname: Chen
authors.forename: Yen-Kung
authors.initials: YK
authors.lastname: Chen
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Jiann-Horng
authors.initials: JH
authors.lastname: Yeh
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D050031:Hashimoto Disease / Q000188:drug therapy / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013974:Thyroxine / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013974:Thyroxine