Venous Thromboembolism in Patients Hospitalized With Thyroid Dysfunction

Danescu, Liviu G.; Badshah, Aaref; Danescu, Septimiu C.; Janjua, Muhammad; Marandici, Anna M.; Matta, Fadi; Yaekoub, Abdo Y.; Malloy, Dennis J.; Stein, Paul D.

doi:10.1177/1076029609336856

Cited by 48 publications

(52 citation statements)

References 28 publications

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“…In the present study, the apparently U-shaped association between TSH levels and risk of VTE supports previous findings that link both hyperthyroidism and subclinical and overt hypothyroidism to a hypercoagulable state (3,4,5,6,7,8,9,10). Previous case-control and case-cohort studies (21,22) have shown that there is a particular association between elevated levels of FT 4 and a risk of VTE.…”

Section: Discussionsupporting

confidence: 91%

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Thyroid function, as assessed by TSH, and future risk of venous thromboembolism: the Tromsø study

Lerstad¹,

Enga²,

Jorde³

et al. 2015

European Journal of Endocrinology

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Objective: The relationship between thyroid function and the risk of venous thromboembolism (VTE) has not been addressed in population-based cohorts. We investigated the association between TSH levels and the risk of VTE in a general adult population. Design: Population-based cohort study. Methods: TSH was measured in 11 962 subjects aged 25-89 years who participated in Tromsø 4-6 starting in 1994-1995. Incident VTE events were recorded through 31st December 2010. Cox's regression models with TSH as a time-varying covariate were used to calculate hazard ratios (HRs) of VTE by TSH categories (low TSH: !0.05 mU/l; moderately reduced TSH: 0.05-0.19 mU/l; normal TSH: 0.20-4.00 mU/l; moderately elevated TSH: 4.01-5.00 mU/l; and high TSH: O5.00 mU/l) and within the normal range of TSH, modeling TSH as a continuous variable. Results: There were 289 VTEs during 8.2 years of median follow-up. Subjects with low (prevalence: 0.22%) and high (3.01%) TSH had slightly higher risk estimates for VTE than did subjects with normal TSH (multivariable HRs: 2.16, 95% CI 0.69-6.76 and 1.55, 95% CI 0.87-2.77 respectively), but the CIs were wide. Moreover, there was no association between TSH within the normal range and VTE (HR per 1 mU/l increase: 0.95, 95% CI 0.82-1.11). Conclusion: Serum levels of TSH within the normal range were not associated with a risk of VTE, whereas low and high TSH levels were rare and associated with a moderately higher risk of VTE. The present findings suggest that only a minor proportion of the VTE risk in the population can be attributed to thyroid dysfunction.

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Section: Discussionsupporting

confidence: 91%

“…A hypercoagulable state has been linked to both hyperthyroidism (3,4,5,6) and subclinical, as well as overt, moderate hypothyroidism (7,8,9,10). A relationship has also been reported between thyroid dysfunction and arterial cardiovascular diseases (CVDs) (11,12).…”

Section: Introductionmentioning

confidence: 99%

Thyroid function, as assessed by TSH, and future risk of venous thromboembolism: the Tromsø study

Lerstad¹,

Enga²,

Jorde³

et al. 2015

European Journal of Endocrinology

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“…25 Preterm birth is associated with diabetes and hypothyroidism, 26,27 which have also been associated with increased risk of VTE. 28,29 Cigarette smoking during pregnancy is a risk factor for preterm birth 30 and may be associated with an increased risk of VTE in the offspring. 13 A better understanding of patterns of human plasticity in response to early nutrition and other environmental factors is needed to further elucidate the link between preterm birth and VTE.…”

Section: Discussionmentioning

confidence: 99%

Gestational Age and Risk of Venous Thromboembolism From Birth Through Young Adulthood

Zöller

Sundquist

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Preterm birth has been associated with increased risk of venous thromboembolism (VTE) in infancy, but the longer-term risk is unknown. WHAT THIS STUDY ADDS:In a large national cohort, low gestational age at birth was associated with increased risk of VTE in infancy, early childhood, and young adulthood. These findings call for better awareness of the long-term risk of VTE among preterm birth survivors. abstract BACKGROUND: Preterm birth has been associated with increased risk of venous thromboembolism (VTE) in infancy, but the longer-term risk is unknown. Our aim was to examine this association from birth through young adulthood.METHODS: National cohort study of 3 571 574 individuals who were live-born in Sweden from 1973 through 2008, including 206 844 born preterm (gestational age ,37 weeks), and followed up to 2010 (ages 0-38 years). The main outcome was VTE.RESULTS: A total of 7 519 (0.2%) individuals were diagnosed with VTE in 70.8 million person-years of follow-up. Low gestational age at birth was associated with VTE in infancy (ages ,1 year: adjusted hazard ratio 47. ), but not in late childhood (ages 6-12 years). Very preterm (,34 weeks) but not late preterm birth (34-36 weeks) was also associated with VTE in adolescence (ages 13-17 years). After further adjustment for comorbidities, these associations were attenuated, but most remained significantly elevated. CONCLUSIONS:In this large national cohort, low gestational age at birth was associated with increased risk of VTE in infancy, early childhood, and young adulthood. Pediatrics 2014;134:e473-e480 Dr Zöller contributed to the conception and design and to analysis and interpretation of data and drafted the initial manuscript; Drs Li and Crump contributed to the conception and design and to analysis and interpretation of data and revised the manuscript; Drs J. Sundquist and K. Sundquist contributed to the conception and design and to acquisition, analysis, and interpretation of data and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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“…Coagulation disorders associated with thyroid disease are usually mild and not associated with sudden death. There are some studies showing an increased risk for unprovoked deep venous thrombosis in patients with subclinical hypothyroidism (3)(4)(5), but there is none, to our knowledge, showing a correlation between hypothyroidism, deep venous thrombosis and sudden death. Overt hypothyroidism is known to be associated with an increased risk of bleeding (6).…”

Section: Introductionmentioning

confidence: 88%

Lethal pulmonary thromboembolism associated with decreased thyroid hormone levels

Hostiuc

Capatina²,

Sinescu

et al. 2015

Arch. Endocrinol. Metab.

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SUMMARYThyroid pathology is rarely involved in the pathogenesis of sudden death in young people. We report here the cases of two young patients with decreased levels of thyroid hormones whose death was caused by an increased thrombotic status, with venous thrombosis and pulmonary thromboembolism. In both cases the thyroid pathology was not considered as the underlying cause of death as the association between this condition and venous thrombosis is still debatable. However its presence may be considered a circumstantial factor, which could increase the severity of the disease and subsequently the lethality rate in pulmonary thromboembolism. An increased awareness for hypothyroidism or subclinical hypothyroidism in clinical practice may lead to a decrease in mortality secondary to thromboembolic disease. Also, increased awareness for thyroid pathology during forensic autopsy in sudden deaths may lead to potentially significant results, that could explain some of the sudden death with an unknown cause, and decrease the number of the so called blank autopsies. Arch Endocrinol Metab. 2015;59(4):355-8

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Venous Thromboembolism in Patients Hospitalized With Thyroid Dysfunction

Cited by 48 publications

References 28 publications

Thyroid function, as assessed by TSH, and future risk of venous thromboembolism: the Tromsø study

Thyroid function, as assessed by TSH, and future risk of venous thromboembolism: the Tromsø study

Gestational Age and Risk of Venous Thromboembolism From Birth Through Young Adulthood

Lethal pulmonary thromboembolism associated with decreased thyroid hormone levels

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