Long-term Effect of Thyrotropin-binding Inhibitor Immunoglobulin on Atrial Fibrillation in Euthyroid Patients
Authors' conclusion
In euthyroid individuals following antithyroid treatment, elevated circulating TBII levels and burden are associated with an elevated risk of long-term incident AF and cardiovascular mortality. Further reduction of TBII level below 35% will benefit to clinical outcomes.
Study context
- Population
- Hyperthyroidism patients with at least 1 thyrotropin-binding inhibiting immunoglobulin (TBII) measurement, National Taiwan University Hospital, 2000–2022
- Participants
- 14,618 patients
- Exposure
- TBII >35% vs lower TBII
- Outcome
- Incident AF and cardiovascular mortality
Methodological detailssingle-centre, electronic medical records, multivariable Cox regression, Kaplan-Meier survival analysis
- Single-centre
- Electronic medical records
- Multivariable Cox regression
- Kaplan-Meier survival analysis
Main finding
As reported in the abstract
AF
Each group vs TBII ≤35%Estimate (CI)P value
TBII >35%
HR (first TBII) 1.48(1.05–2.08)
P = 0.027TBII >35%
HR (mean TBII) 1.91(1.37–2.65)
P < 0.001- Developed atrial fibrillation (AF)
- 173
Observational data: associations, not effects.
Further findings
AF after FT4 normalised
- Higher mean TBII increased AF, HR 1.78 [1.11-2.85]
- P = 0.017
Cardiovascular mortality
- Higher first TBII burden, HR 6.73 [1.42-31.82]
- P = 0.016
- Higher mean TBII burden, HR 7.87 [1.66-37.20]
- P = 0.009
Kaplan-Meier: AF and cardiac mortality with elevated TBII
- Elevated TBII levels increased the risk of AF
- log-rank P = .035
- Elevated TBII levels increased the risk of cardiac mortality
- log-rank P = .027
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Long-term Effect of Thyrotropin-binding Inhibitor Immunoglobulin on Atrial Fibrillation in Euthyroid Patients. Endocr Pract. Published 2 April 2024. doi:10.
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