Association between Sensitivity to Thyroid Hormones and Risk of Arrhythmia in Patients with Coronary Heart Disease: A RCSCD-TCM study in China

Abstract

BackgroundThyroid dysfunction is closely related to arrhythmia. However, the relationship between sensitivity to thyroid hormone and risk of arrhythmia remains unknown. This study aimed to investigate the association between the thyroid system complex index and risk of arrhythmia in patients with coronary heart disease (CHD).MethodsThis large, multi-center study included 28,413 patients with CHD. Central sensitivity to thyroid hormone was assessed by calculating the thyroid feedback quantile-based index (TFQI). Logistic regression was used to analyze the relationship between sensitivity to thyroid hormone and risk of arrhythmia. This study also assessed the relationship between sensitivity to thyroid hormone and risk of arrhythmia in different sexes, ages, and glucose regulation and blood lipid states.ResultsOf the 28,413 participants, 8,935 (31.4%) patients with CHD had arrhythmia. There was a remarkable association between TFQI and risk of arrhythmia (odds ratio [OR]: 0.783; 95% confidence interval [CI], 0.735–0.836). Furthermore, the association between the TFQI and risk of arrhythmia in women (OR: 0.731; 95% CI: 0.667–0.802) was stronger than that in men (OR: 0.894; 95% CI: 0.816–0.910), as well as higher in elder (OR: 0.779; 95% CI: 0.721–0.843) than middle-aged (OR: 0.789; 95% CI: 0.703–0.886) patients. Furthermore, the association was stronge in the state of diabetes (OR: 0.635; 95% 0.569–0.709) and dyslipidemia (OR: 0.706; 95% CI: 0.644–0.774).ConclusionThere is a remarkable association between sensitivity to thyroid hormone and risk of arrhythmia in patients with CHD, which is more pronounced among women and the elderly. The association is also stronger in patients with dyslipidemia or diabetes.

Prescription patterns of antidiabetic and cardiovascular preventive medications in community-dwelling older adults with type 2 diabetes mellitus: a cross-sectional study

“…[6,19] Sulfonylureas were the second most commonly used oral antidiabetic in our study. These findings come in line with the results of Hannan, et al, [30] where more than 50% of participants received sulfonylurea. Although the efficacy of sulfonylureas in T2DM management is well established, the high risk of hypoglycemia, especially with glyburide, limits its benefit in elderly patients, however it is still highly prescribed in this population due to its low cost.…”

“…Although the efficacy of sulfonylureas in T2DM management is well established, the high risk of hypoglycemia, especially with glyburide, limits its benefit in elderly patients, however it is still highly prescribed in this population due to its low cost. [29,30] Interestingly, the collective recommendations for the use of evidence-based therapies with recognized cardiovascular benefit were not met in the majority of observed participants in this study, where only one in twentyone patients collectively received all of the three therapies, and one in seven patients were prescribed an antihyperglycemic agent with cardiovascular benefit. These findings come in line with those recently reported in the United States by Nelson, et al, [11] where less than one in twenty patients were prescribed all three medication classes with a marked limitation in the prescription of antihyperglycemic agents with cardiovascular benefit.…”