Thyroid Function Associated With Atherosclerotic Cardiovascular Morbidity and Mortality Interview with:
Arjola Bano, MD, DSc

PhD candidate
Departments of Internal Medicine and Epidemiology
Erasmus Medical Center, Rotterdam, The Netherlands What is the background for this study? What are the main findings?

Response: Atherosclerosis is a chronic condition, characterized by the accumulation of lipids and fibrous elements in the arterial walls. It can progress insidiously from an asymptomatic narrowing of the arterial lumen (subclinical phase) to the clinical onset of vascular events (as coronary heart disease or stroke) and death. Despite advances in prevention and treatment, atherosclerotic diseases remain a leading cause of mortality worldwide. Therefore, identifying additional modifiable risk factors for atherosclerosis is of major importance.

So far, the role of thyroid hormone on atherosclerosis remains unclear. Moreover, a comprehensive investigation exploring the link of thyroid function with the wide spectrum of atherosclerosis, including subclinical atherosclerosis, clinical atherosclerosis and atherosclerotic mortality, within the same population is lacking.

Therefore, in a prospective study of 9231 middle-aged and elderly people, we explored the association of thyroid function with subclinical atherosclerosis (coronary artery calcification), atherosclerotic events (fatal and nonfatal coronary heart disease or stroke) and atherosclerotic mortality (death from coronary heart disease, cerebrovascular or other atherosclerotic disease). Higher free thyroxine (FT4) levels were associated with higher risk of subclinical atherosclerosis, atherosclerotic events and atherosclerotic mortality, independently of cardiovascular risk factors.

The risk of atherosclerotic mortality increased with higher FT4 levels (HR; CI: 2.35; 1.61-3.41 per 1 ng/dl) and lower thyroid-stimulating hormone (TSH) levels (HR; CI: 0.92; 0.84-1.00 per 1 logTSH), with stronger estimates among participants with a history of atherosclerotic disease (HR; CI: 5.76; 2.79-11.89 for FT4 and 0.81; 0.69-0.95 for TSH). What should readers take away from your report?

Response: Higher FT4 levels in middle-aged and elderly people are associated with an increased risk of subclinical and clinical manifestations of atherosclerosis, independently of cardiovascular risk factors. What recommendations do you have for future research as a result of this study?

Response: Our findings suggest that FT4 measurement could be a potential marker for predicting atherosclerotic mortality, especially among subjects with atherosclerotic disease. Moreover, our findings underscore the importance of identifying the modifiable mediators of the association between thyroid function and atherogenesis. Preventive strategies targeting thyroid function or certain mediators could further lead to a reduction in atherosclerotic events. However, further research is needed to replicate our findings and investigate potential implications.

The authors have no conflicts of interest with the study. Thank you for your contribution to the community.

The Association of Thyroid Function with Atherosclerotic Cardiovascular Morbidity and Mortality: New Insights from the Rotterdam Stud
Arjola Bano*1, Layal Chaker2, Francesco U.S. Mattace-Raso3, Oscar H. Franco4, Maryam Kavousi5 and Robin P. Peeters2
1Erasmus Medical Center, Rotterdam, NETHERLANDS, 2Erasmus Medical Center, Rotterdam, Netherlands, 3Erasmus University Medical Center, Rotterdam, Rotterdam, Netherlands, 4Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands, 5Erasmus MC, Rotterdam, Netherlands

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on April 9, 2017 by Marie Benz MD FAAD