Major Adverse Cardiovascular Events (MACE) and Hyperthyroidism Treated With Medication, Radioactive Iodine, or Thyroidectomy
Authors' conclusion
In this study, surgery was associated with lower long-term risks of MACE and all-cause mortality, while RAI was associated with a lower MACE risk compared with ATDs.
Study context
- Population
- Patients aged ≥20 years with newly diagnosed hyperthyroidism 2011–2020, Taiwan; mean (SD) age 44.1 (13.6) years, 73.2% female
- Participants
- 114,062 patients
- Exposure
- Surgery or radioactive iodine (RAI) vs antithyroid drugs
- ATDsn = 107,052reference
- RAIn = 1,238
- Surgeryn = 5,772
- Outcome
- MACE (acute MI, stroke, HF, cardiovascular mortality) and all-cause mortality
- Follow-up
- Mean (SD) 4.4 (2.5) years
Methodological detailsTaiwan National Health Insurance Research Database, Treatment groups determined within 18 months from diagnosis, Data analyzed October 2022 through December 2023
- Taiwan National Health Insurance Research Database
- Treatment groups determined within 18 months from diagnosis
- Data analyzed October 2022 through December 2023
Main finding
As reported in the abstract
Each group vs ATDsHazard ratio (95% CI)P value
SurgeryMACE
0.76(0.59–0.98)
P = 0.04Surgeryall-cause mortality
0.53(0.41–0.68)
P < 0.001RAIMACE
0.45(0.22–0.93)
P = 0.03Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| HFSurgeryvs ATDs | 0.33 (0.18–0.59) | P < 0.001 | |
| Cardiovascular mortalitySurgeryvs ATDs | 0.45 (0.26–0.79) | P = 0.005 | |
| 0.20.5125Hazard ratio (log scale) |
Acute MI and stroke
- Risks for acute MI and stroke did not significantly differ between treatment groups
Original publication
MACE and Hyperthyroidism Treated With Medication, Radioactive Iodine, or Thyroidectomy. JAMA Netw Open. Published 4 March 2024. doi:10.
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