The DOI matches its Crossref record; 49 of the 50 references it cites were found in a registry or an index.
Subclinical hyperthyroidism as a risk factor for atrial fibrillation
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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“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“>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]
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Metadata
- 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)
- 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
- 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 ›
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