Incident atrial fibrillation in patients with differentiated thyroid cancer: a meta-analysis

Research output: Contribution to journalArticlepeer-review

Authors

  • Georgios Kostopoulos
  • Ioannis Doundoulakis
  • Christina Antza
  • Emmanouil Bouras
  • Dimitrios Tsiachris
  • Gregory Y H Lip
  • Konstantinos A Toulis

Colleges, School and Institutes

External organisations

  • Aristotle University of Thessaloniki
  • Liverpool Heart and Chest Hospital NHS Foundation Trust

Abstract

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.

Details

Original languageEnglish
Pages (from-to)325-335
JournalEndocrine-related cancer
Volume28
Issue number5
Publication statusPublished - 29 Apr 2021