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Higher free thyroxine levels may increase sudden cardiac death risk

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An increased risk for sudden cardiac death was found with higher free thyroxine levels, even in patients with normal thyroid function, according to recent study findings presented at the 15th International Thyroid Congress and 85th Annual Meeting of the American Thyroid Association.

“The association between thyroid function and several cardiovascular diseases has clearly been established, but no studies to date have assessed the relation with sudden cardiac death,” the researchers wrote.

Layal Chaker, an MD, PhD, student at Erasmus Medical Center in the Netherlands, and colleagues evaluated data from the Rotterdam Study on 10,318 adults aged 45 years or older to determine the relationship between thyroid function and sudden cardiac death. Follow-up was conducted for a mean 9.1 years.

Overall, there was 261 incident sudden cardiac death events. A higher risk for sudden cardiac death in the full range was found with the highest tertile of free T₄ levels (HR = 1.35; 95% CI, 1.01-1.83) and normal range thyroid function (HR = 1.4; 95% CI, 1.02-1.95). Risk estimates were not altered by stratification by age or sex and sensitivity analyses.

In participants with normal thyroid function and free T₄ levels within the normal range, absolute 10-year risks for sudden cardiac death increased with increasing free T₄ levels from 1% to 4%.

“Higher [free] T₄ levels are associated with increased relative and absolute risks of [sudden cardiac death], even in euthyroid subjects,” the researchers wrote. “[Free] T₄ levels might be used for risk stratification in the general population, but the additional benefit of adding thyroid function to prediction models or screening modules for [sudden cardiac death] still has to be determined.” – by Amber Cox

Reference:

Chaker L, et al. Oral 457. Presented at: 15th International Thyroid Congress and 85th Annual Meeting of the American Thyroid Association (ITC/ATA); Oct. 18-23, 2015; Lake Buena Vista, Fla.

Disclosure: Chaker reports no relevant financial disclosures.