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TSH variability and atrial fibrillation in patients with DTC : A regional cohort study

Zoltek, Maximilian ; Andersson, Therese M.L. ; Hedman, Christel LU ; Nordenvall, Caroline and Lundgren, Catharina I. (2025) In Scandinavian Journal of Surgery 114(4). p.446-452
Abstract

Background: The study aimed to analyze thyroid-stimulating hormone (TSH) levels quantitatively and investigate their potential correlation with the risk of incident atrial fibrillation (AF) in differentiated thyroid cancer (DTC) patients. Methods: DTC cases diagnosed between 1995 and 2015 in Stockholm, Sweden, were identified from the Swedish Cancer Registry. Medical records were scrutinized, and follow-up began 9 months post-surgery with tracking data until the earliest AF record, censoring, or 31 August 2022. TSH values were classified as unsuppressed (TSH > 0.5 mE/L), mildly suppressed (TSH 0.1–0.5 mE/L), or suppressed (TSH < 0.1 mE/L), with graphical analysis spanning up to a 10-year follow-up period. In addition, a... (More)

Background: The study aimed to analyze thyroid-stimulating hormone (TSH) levels quantitatively and investigate their potential correlation with the risk of incident atrial fibrillation (AF) in differentiated thyroid cancer (DTC) patients. Methods: DTC cases diagnosed between 1995 and 2015 in Stockholm, Sweden, were identified from the Swedish Cancer Registry. Medical records were scrutinized, and follow-up began 9 months post-surgery with tracking data until the earliest AF record, censoring, or 31 August 2022. TSH values were classified as unsuppressed (TSH > 0.5 mE/L), mildly suppressed (TSH 0.1–0.5 mE/L), or suppressed (TSH < 0.1 mE/L), with graphical analysis spanning up to a 10-year follow-up period. In addition, a nested case–control study assessed the impact of TSH category on incident AF. Additional data on cardiovascular risk factors were gathered. Results: Among 608 patients, approximately 78% maintained suppressed TSH levels for over half of their follow-up time. Notably, there was a decrease in the proportion of patients receiving long-term TSH suppression after 2013. Among 39 newly diagnosed AF cases, most were in the suppressed TSH category. Moreover, about half of these new AF patients had established cardiovascular risk factors prior to DTC diagnosis. Conclusion: DTC patients generally adhered to TSH suppression guidelines, with a decline observed in the proportion of suppressed TSH values following the adoption of individualized treatment in 2013. The study could not establish a clear link between TSH suppression and the risk of incident AF, highlighting the need for further investigation.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiovascular disease, differentiated thyroid cancer, TSH
in
Scandinavian Journal of Surgery
volume
114
issue
4
pages
446 - 452
publisher
Finnish Surgical Society
external identifiers
  • pmid:40796370
  • scopus:105013506022
ISSN
1457-4969
DOI
10.1177/14574969251364947
language
English
LU publication?
yes
id
d5587583-177b-4637-ad56-6b65d8d8e308
date added to LUP
2025-11-19 11:48:50
date last changed
2025-12-19 16:19:16
@article{d5587583-177b-4637-ad56-6b65d8d8e308,
  abstract     = {{<p>Background: The study aimed to analyze thyroid-stimulating hormone (TSH) levels quantitatively and investigate their potential correlation with the risk of incident atrial fibrillation (AF) in differentiated thyroid cancer (DTC) patients. Methods: DTC cases diagnosed between 1995 and 2015 in Stockholm, Sweden, were identified from the Swedish Cancer Registry. Medical records were scrutinized, and follow-up began 9 months post-surgery with tracking data until the earliest AF record, censoring, or 31 August 2022. TSH values were classified as unsuppressed (TSH &amp;gt; 0.5 mE/L), mildly suppressed (TSH 0.1–0.5 mE/L), or suppressed (TSH &amp;lt; 0.1 mE/L), with graphical analysis spanning up to a 10-year follow-up period. In addition, a nested case–control study assessed the impact of TSH category on incident AF. Additional data on cardiovascular risk factors were gathered. Results: Among 608 patients, approximately 78% maintained suppressed TSH levels for over half of their follow-up time. Notably, there was a decrease in the proportion of patients receiving long-term TSH suppression after 2013. Among 39 newly diagnosed AF cases, most were in the suppressed TSH category. Moreover, about half of these new AF patients had established cardiovascular risk factors prior to DTC diagnosis. Conclusion: DTC patients generally adhered to TSH suppression guidelines, with a decline observed in the proportion of suppressed TSH values following the adoption of individualized treatment in 2013. The study could not establish a clear link between TSH suppression and the risk of incident AF, highlighting the need for further investigation.</p>}},
  author       = {{Zoltek, Maximilian and Andersson, Therese M.L. and Hedman, Christel and Nordenvall, Caroline and Lundgren, Catharina I.}},
  issn         = {{1457-4969}},
  keywords     = {{cardiovascular disease; differentiated thyroid cancer; TSH}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{446--452}},
  publisher    = {{Finnish Surgical Society}},
  series       = {{Scandinavian Journal of Surgery}},
  title        = {{TSH variability and atrial fibrillation in patients with DTC : A regional cohort study}},
  url          = {{http://dx.doi.org/10.1177/14574969251364947}},
  doi          = {{10.1177/14574969251364947}},
  volume       = {{114}},
  year         = {{2025}},
}