TY - JOUR
T1 - Incident atrial fibrillation in patients with differentiated thyroid cancer
T2 - a meta-analysis
AU - Kostopoulos, Georgios
AU - Doundoulakis, Ioannis
AU - Antza, Christina
AU - Bouras, Emmanouil
AU - Nirantharakumar, Krishnarajah
AU - Tsiachris, Dimitrios
AU - Thomas, G Neil
AU - Lip, Gregory Y H
AU - Toulis, Konstantinos A
PY - 2021/4/29
Y1 - 2021/4/29
N2 - Differentiated thyroid cancer (DTC) represents the most common form of thyroid neoplasms and is becoming increasingly prevalent. Evidence suggests a possible relationship between DTC diagnosis and subsequent atrial fibrillation (AF). If confirmed, this may present an alarming health risk (AF) in an otherwise condition with a relatively good prognosis (DTC). The aim of this systematic review and meta-analysis is to provide for the first time a pooled estimate of AF incidence in DTC patients in comparison to healthy controls. A detailed search in electronic databases, clinical trial registries and grey literature was performed to identify studies reporting the incidence of AF in DTC patients. Newcastle-Ottawa quality assessment scale was used to assess study quality. We used a random effects (RE) generalized linear mixed model (GLMM) in pooling of individual studies and also calculated a prediction interval for the estimate of a new study. Six observational studies met the eligibility criteria, which included totally 187,754 patients with DTC and 199,770 healthy controls. The median follow-up period was 4.3 to 18.8 years; the incidence rate of AF was 4.86 (95% CI, 3.29 to 7.17, I2= 96%) cases per 1000 person-years, while the incidence rate ratio was 1.54(95%CI, 1.44 to 1.65, I2 = 0%, 95%PI, 1.33 to 1.78).This is the first meta-analysis to confirm that patients with DTC are at a high risk for developing AF, which may be attributed to a state of iatrogenic hyperthyroidism due to long-term thyrotropin suppression therapy.
AB - Differentiated thyroid cancer (DTC) represents the most common form of thyroid neoplasms and is becoming increasingly prevalent. Evidence suggests a possible relationship between DTC diagnosis and subsequent atrial fibrillation (AF). If confirmed, this may present an alarming health risk (AF) in an otherwise condition with a relatively good prognosis (DTC). The aim of this systematic review and meta-analysis is to provide for the first time a pooled estimate of AF incidence in DTC patients in comparison to healthy controls. A detailed search in electronic databases, clinical trial registries and grey literature was performed to identify studies reporting the incidence of AF in DTC patients. Newcastle-Ottawa quality assessment scale was used to assess study quality. We used a random effects (RE) generalized linear mixed model (GLMM) in pooling of individual studies and also calculated a prediction interval for the estimate of a new study. Six observational studies met the eligibility criteria, which included totally 187,754 patients with DTC and 199,770 healthy controls. The median follow-up period was 4.3 to 18.8 years; the incidence rate of AF was 4.86 (95% CI, 3.29 to 7.17, I2= 96%) cases per 1000 person-years, while the incidence rate ratio was 1.54(95%CI, 1.44 to 1.65, I2 = 0%, 95%PI, 1.33 to 1.78).This is the first meta-analysis to confirm that patients with DTC are at a high risk for developing AF, which may be attributed to a state of iatrogenic hyperthyroidism due to long-term thyrotropin suppression therapy.
UR - http://www.scopus.com/inward/record.url?scp=85105896134&partnerID=8YFLogxK
U2 - 10.1530/ERC-20-0496
DO - 10.1530/ERC-20-0496
M3 - Article
C2 - 33794503
SN - 1351-0088
VL - 28
SP - 325
EP - 335
JO - Endocrine-related cancer
JF - Endocrine-related cancer
IS - 5
ER -
