Format

Send to

Choose Destination
PLoS One. 2015 Jun 12;10(6):e0129793. doi: 10.1371/journal.pone.0129793. eCollection 2015.

Levothyroxine Substitution in Patients with Subclinical Hypothyroidism and the Risk of Myocardial Infarction and Mortality.

Author information

1
Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark.
2
Elective Laboratory of the Capital Region, Copenhagen, Denmark.
3
Department of Endocrinology, Herlev University Hospital, Herlev, Denmark; Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
4
Department of Health Science and Technology, University of Aalborg, Aalborg, Denmark.
5
Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark; Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, Denmark; The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
6
Department of Internal Medicine, Amager University Hospital, Amager, Denmark.

Abstract

BACKGROUND:

Subclinical hypothyroidism is associated with a number of cardiovascular risk factors, yet only limited data exist on long-term outcome of levothyroxine treatment of this condition with respect to hard end-points. The aim of this retrospective cohort study was to determine effects of levothyroxine treatment on myocardial infarction (MI), cardiovascular death and all-cause mortality, in patients with subclinical hypothyroidism.

METHODS AND RESULTS:

Primary care patients aged 18 years and older that underwent thyroid function tests between 2000 and 2009 were enrolled. Participants were identified by individual-level linkage of nationwide registers. Patients with subclinical hypothyroidism at baseline were included in the study. Exclusion criteria included a history of thyroid disease, related medication or medication affecting thyroid function. The total cohort comprised 628,953 patients of which 12,212 (1.9%) had subclinical hypothyroidism (mean age 55.2 [SD ± 18.8] years; 79.8% female). Within the first six months 2,483 (20.3%) patients claimed a prescription for levothyroxine. During a median follow-up of 5.0 (IQR: 5.2) years, 358 MI's and 1,566 (12.8%) deaths were observed. Out of these, 766 of the deaths were cardiovascular related. No beneficial effects were found in levothyroxine treated patients on MI (IRR 1.08 [95% CI: 0.81 to 1.44]), cardiovascular death (IRR 1.02 [95% CI: 0.83 to 1.25]) or all-cause mortality (IRR 1.03 [95% CI: 0.90 to 1.19]), except in patients under the age of 65 years (IRR 0.63 [95% CI: 0.40 to 0.99]).

CONCLUSION:

Levothyroxine substitution in subclinical hypothyroid patients does not indicate an association with lower mortality or decreased risk of MI.

PMID:
26069971
PMCID:
PMC4466400
DOI:
10.1371/journal.pone.0129793
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center