Iodine-Induced Hyperthyroidism and Long-term Risks of Incident Atrial Fibrillation and Flutter
Main finding · Incident atrial fibrillation/flutterResult — go to the resultAdjusted hazard ratio 1.19 95% CI 1.06–1.33Authors' conclusion
Hyperthyroidism following a high iodine load was associated with an increased risk of incident atrial fibrillation/flutter, particularly among females. The observed sex-based differences should be confirmed in a more sex-diverse study sample, and the cost-benefit analysis of long-term monitoring for cardiac arrhythmias following iodine-induced hyperthyroidism should be evaluated.
Study context
- Population
- Veterans aged ≥18 years with normal baseline TSH, subsequent TSH <1 year, and iodine contrast <60 days before the subsequent TSH; mean age 60.9 years, 88% men
- Participants
- 44,607 veterans
- Exposure
- Iodine-induced hyperthyroidism vs iodine-induced euthyroidism
- Iodine-induced hyperthyroidismn = 2,500
- Outcome
- Incident atrial fibrillation/flutter
- Follow-up
- Median 3.7 years (IQR 1.9-7.4)
Methodological detailsU.S. Veterans Health Administration (1998-2021), Cox proportional hazards regression
- U.S. Veterans Health Administration (1998-2021)
- Cox proportional hazards regression
Main finding
As reported in the abstract
Adjusted hazard ratio
1.19
95% CI 1.06–1.33
Iodine-induced hyperthyroidismvs Iodine-induced euthyroidism
aHR 1.19 (95% CI 1.06–1.33)
- Atrial fibrillation/flutter overall
- 10.4%
Observational data: associations, not effects.
Further findings
Incident AF/flutter by sex
- Females, HR
- 1.81 (1.12-2.92) (95% CI)
- Males, HR
- 1.15 (1.03-1.30) (95% CI)
- P for interaction
- P for interaction = 0.04
- Females at greater risk for incident AF/flutter than males
Original publication
Iodine-Induced Hyperthyroidism and Long-term Risks of Incident Atrial Fibrillation and Flutter. J Clin Endocrinol Metab. Published 5 May 2023. doi:10.
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