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Subclinical Thyroid Dysfunction, Cardiac Function, and the Risk of Heart Failure

The Cardiovascular Health Study

Nicolas Rodondi, MD, MAS^_*,_*, Douglas C. Bauer, MD^,, Anne R. Cappola, MD, ScM, Jacques Cornuz, MD, MPH^_*, John Robbins, MD, MHS^||, Linda P. Fried, MD, MPH^¶, Paul W. Ladenson, MD^#, Eric Vittinghoff, PhD, John S. Gottdiener, MD, FACC^_** and Anne B. Newman, MD, MPH

^_* Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
Department of Epidemiology and Biostatistics, University of California, San Francisco, California
Division of General Internal Medicine, University of California, Department of Medicine, San Francisco, California
Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
^|| University of California, Davis, Sacramento, California
^¶ Division of Geriatric Medicine and Gerontology and Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland
^# Division of Endocrinology and Metabolism, Department of Medicine, Johns Hopkins, University School of Medicine, Baltimore, Maryland
^_** Echocardiography Laboratory, Division of Cardiology, University of Maryland Hospital, Baltimore, Maryland
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

View larger version (14K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Incident HF Events According to TSH Levels Participants with TSH 10.0 to 19.9 mU/l who were untreated by thyroxine replacement (participants censored at the time of first thyroxine use) had a greater incidence of HF events compared with euthyroid participants (41.7 vs. 22.9 per 1,000 person-years, p = 0.01), but rates were similar for those with subclinical hyperthyroidism or those with TSH between 4.5 and 9.9 mU/l. HF = heart failure; TSH = thyroid-stimulating hormone.