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Differentiated thyroid cancer tripled risk for cardiovascular mortality
Patients with differentiated thyroid cancer were at three times the risk for cardiovascular mortality and four times the risk for all-cause mortality compared with the general population, according to results of an observational study.
The analysis included 524 patients with differentiated thyroid cancer and an additional cohort of 1,572 sex- and age-matched adults from the general population who served as controls.
Median follow-up was 8.5 years for patients with thyroid cancer and 10.5 years for the controls.
During those times, 100 patients (19.1%) with cancer and 85 individuals (5.4%) in the control arm died. Cardiovascular disease accounted for 22 (4.2%) of deaths in the thyroid cancer arm and 24 (1.5%) in the control arm.
After adjustments for age, sex and cardiovascular risk factors, differentiated thyroid cancer was associated with an increased risk for cardiovascular mortality (HR=3.35; 95% CI, 1.66-6.74) and all-cause mortality (HR=4.40; 95% CI, 3.15-6.14).
Researchers also determined lower levels of thyroid-stimulating hormone (TSH) were associated with increased risk for cardiovascular mortality (P<.001) and all-cause mortality (P<.001) in patients with thyroid cancer.
Researchers calculated a 2.95 HR (95% CI, 1.32-6.59) for cardiovascular mortality and a 2.57 HR (95% CI, 1.75-3.79) for all-cause mortality for each 10-fold decrease in geometric mean of TSH levels. After adjustments for age, sex, cardiovascular risk factors and other criteria, TSH levels significantly predicted cardiovascular mortality (HR=3.08; 95% CI, 1.32-7.21), but the association was not significant for all-cause mortality (HR=1.43; 95% CI, 0.97-2.12).
“These results therefore provide important data to support the current European Thyroid Association and American Thyroid Association guidelines of lowering thyroid hormone suppression therapy in patients with a low risk for cancer recurrence,” the researchers wrote. “Furthermore, these results stress the importance of a close follow-up and could encourage assessment and treatment of cardiovascular risk factors during follow-up for differentiated thyroid carcinoma.”
Disclosure: The researchers report no relevant financial disclosures.