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  • Wändell, PerKarolinska Institutet,Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden. (author)

Comparison of mortality and nonfatal cardiovascular events in adults with atrial fibrillation with versus without levothyroxine treatment

  • Article/chapterEnglish2017

Publisher, publication year, extent ...

  • Elsevier BV,2017
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:du-26360
  • https://urn.kb.se/resolve?urn=urn:nbn:se:du-26360URI
  • https://doi.org/10.1016/j.amjcard.2017.08.013DOI
  • https://lup.lub.lu.se/record/0026dae7-403f-482b-9a87-5b8e8db09a1dURI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:137299356URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-340272URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Levothyroxine has been suggested to be cardiotoxic, but previous studies on the risk of cardiovascular events associated with levothyroxine treatment have been inconclusive. We aimed to study the association between levothyroxine treatment and all-cause mortality as well as cardiovascular events. Study population included all adults (n = 12,283) ≥ 45 years diagnosed with atrial fibrillation (AF) at 75 primary care centers in Sweden in 2001 to 2007, with (n = 1,189; 283 men and 906 women) or without (n = 11,094) levothyroxine treatment. Outcome was defined as all-cause mortality and cardiovascular events, that is, myocardial infarction, ischemic stroke, and congestive heart failure until December 31, 2010. During a mean 5.8 years (standard deviation 2.4 years) of follow-up, a total of 3,954 patients died (32.2%), among whom 92 men (32.5%) and 266 women (29.4%) were treated with levothyroxine. In fully adjusted Cox regression models (age, co-morbidity, socioeconomic factors, and warfarin treatment), a significant association between levothyroxine treatment and lower mortality was found among women (hazard ratio 0.78, 95% confidence interval 0.68 to 0.91), but not among men (hazard ratio 0.87, 95% confidence interval 0.69 to 1.10). In the secondary analysis, levothyroxine treatment was not associated with the risk of myocardial infarction, ischemic stroke, or congestive heart failure (p > 0.05). In conclusion, in a large representative cohort, we found that levothyroxine treatment decreased the mortality risk in women with AF, which suggests that such treatment could be of benefit in this setting.

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  • Carlsson, Axel CUppsala universitet,Karolinska Institutet,Uppsala University,Kardiovaskulär epidemiologi,Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden(Swepub:uu)axeca883 (author)
  • Holzmann, Martin JKarolinska Institutet,Karolinska Univ Hosp, Funct Area Emergency Med, Stockholm, Sweden.;Solna Karolinska Inst, Dept Internal Med, Stockholm, Sweden. (author)
  • Ärnlöv, Johan,1970-Uppsala universitet,Karolinska Institutet,Dalarna University College,Högskolan Dalarna,Medicinsk vetenskap,Karolinska institutet; Uppsala universitet,Kardiovaskulär epidemiologi,Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden.(Swepub:uu)johaarnl (author)
  • Sundquist, JanLund University,Lunds universitet,Allmänmedicin och klinisk epidemiologi,Forskargrupper vid Lunds universitet,Family Medicine and Clinical Epidemiology,Lund University Research Groups,Icahn School of Medicine at Mount Sinai,Lund Univ, Ctr Primary Hlth Care Res, Malmo, Sweden.;Icahn Sch Med Mt Sinai, Dept Family Med & Community Hlth, New York, NY 10029 USA.;Icahn Sch Med Mt Sinai, Dept Populat Hlth Sci & Policy, New York, NY 10029 USA.(Swepub:lu)med-jsu (author)
  • Sundquist, KristinaLund University,Lunds universitet,Allmänmedicin, kardiovaskulär epidemiologi och levnadsvanor,Forskargrupper vid Lunds universitet,Family Medicine, Cardiovascular Epidemiology and Lifestyle,Lund University Research Groups,Icahn School of Medicine at Mount Sinai,Lund Univ, Ctr Primary Hlth Care Res, Malmo, Sweden.;Icahn Sch Med Mt Sinai, Dept Family Med & Community Hlth, New York, NY 10029 USA.;Icahn Sch Med Mt Sinai, Dept Populat Hlth Sci & Policy, New York, NY 10029 USA.(Swepub:lu)med-ksq (author)
  • Karolinska InstitutetKarolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden. (creator_code:org_t)

Related titles

  • In:American Journal of Cardiology: Elsevier BV120:11, s. 1974-19790002-91491879-1913

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