CoChat
Sign Up
Cited by 314Thyroid Disorders and TreatmentsAtrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmias

Subclinical hyperthyroidism as a risk factor for atrial fibrillation

Auer, Johann, Scheibner, Peter, Mische, Thomas, Langsteger, Werner, Eber, Otto, Eber, Bernd·2001·American Heart Journal
DOI 10.1067/mhj.2001.119370
Open this paper in CoChat — free account

Abstract

Objectives Atrial fibrillation is a well-known manifestation of hyperthyroidism. We studied whether subclinical hyperthyroidism with low serum thyrotropin concentrations and free thyroid hormone concentrations within the normal range in clinically euthyroid persons is a risk factor for subsequent atrial fibrillation.Methods We studied 23,638 persons. The subjects were classified according to their serum thyrotropin concentrations: group 1 comprised those with normal values of serum thyrotropin concentration (>0.4-5.0 mU/L) and free tri-iodothyronine and free thyroxine concentrations were within the normal range (22,300 subjects), group 2 comprised those with both low serum thyrotropin values (</=0.03 mU/L) and elevated free tri-iodothyronine and free thyroxine concentrations (725 subjects), and group 3 comprised those with low values of serum thyrotropin (<0.4 mU/L) and free triiodothyronine and free thyroxine concentrations were within the normal range (613 subjects).Results Atrial fibrillation was present in 513 persons (2.3%) in group 1 with normal values for serum thyrotropin, 100 (13.8%) in group 2 with overt hyperthyroidism, and 78 (12.7%) in group 3 with subclinical hyperthyroidism. The prevalence of atrial fibrillation in patients with low serum thyrotropin concentrations (<0.4 mU/L) was 13.3% compared with 2.3% in patients with normal values for serum thyrotropin (P <.01). The relative risk of atrial fibrillation in subjects with low serum thyrotropin and normal free tri-iodothyronine and free thyroxine concentrations, compared with those with normal concentrations of serum thyrotropin, was 5.2 (95% CI 2.1-8.7, P <.01).Conclusion A low serum thyrotropin concentration is associated with a >5-fold higher likelihood for the presence of atrial fibrillation with no significant difference between subclinical and overt hyperthyroidism.

Integrity signals

Registry

Crossref · 10.1067/mhj.2001.119370

Cites

50 of 50 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Cardiovascular morbidity and mortality are particularly increased in men, in elderly patients with high-normal FT4 levels and in patients with underlying heart disease.

    “Cardiovascular morbidity and mortality are particularly increased in men, in elderly patients with high-normal FT 4 levels and in patients with underlying heart disease [71-73, 76, 77, 87, 91, 92, 94] .”

    From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [72]

  • A greater risk of atrial fibrillation was documented in individuals with serum TSH <0.1 mIU/l and underlying heart disease.

    “A greater risk of AF was also documented in individuals with serum TSH <0.1 mIU/l and underlying heart disease [72] .”

    From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [72]

  • Excess thyroid hormone can increase the risk of arrhythmias and muscle weakness in older people, which can contribute to a greater risk of falls.

    “Excess thyroid hormone can also increase the risk of arrhythmias24 25 and muscle weakness23 in older people, which can contribute to a greater risk of falls.”

    From Levothyroxine dose and risk of fractures in older adults: nested case-control study (2011) · cites this paper as [25]

  • Older patients with low TSH and higher fT4 have a higher prevalence and incidence of atrial fibrillation compared with euthyroid subjects.

    “Older patients with low TSH and higher fT4 have a higher prevalence and incidence of atrial fibrillation compared with euthyroid subjects (94–98)”

    From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [98]

  • Patients with subclinical or overt hyperthyroidism have a >5-fold higher likelihood of atrial fibrillation.

    “>5-fold higher likelihood for the presence of atrial fibrillation in both patients with subclinical and overt hyperthyroidism (98).”

    From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [98]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Auer, J., Scheibner, P., Mische, T., Langsteger, W., Eber, O., & Eber, B.
Affiliations
Klinikum Wels-Grieskirchen (AT)
ORCID
Auer, Johann
Venue
American Heart Journal
Publisher
Elsevier BV
Published
2001-11
Volume
142
Issue
5
Pages
838-842
ISSN
0002-8703 (ISSN-L)
DOI
10.1067/mhj.2001.119370
OpenAlex
W2040416944
Cited by
314
References
50
Citations by year
2026: 4 · 2025: 7 · 2024: 4 · 2023: 8 · 2022: 14 · 2021: 10 · 2020: 8 · 2019: 14 · 2018: 12 · 2017: 11 · 2016: 11 · 2015: 14 · 2014: 12 · 2013: 25 · 2012: 16
FWCI
6.43
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Heart Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
subclinical hyperthyroidism, atrial fibrillation, serum thyrotropin, free triiodothyronine, free thyroxine, overt hyperthyroidism, risk factors, thyroid function
MeSH terms
Atrial Fibrillation, Humans, Hyperthyroidism, Middle Aged, Risk Factors, Thyrotropin, Thyroxine, Triiodothyronine, Comorbidity

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review