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

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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

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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.

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Background
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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

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Subclinical hyperthyroidism as a risk factor for atrial fibrillation

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