Incident atrial fibrillation in patients with differentiated thyroid cancer: a meta-analysis



Kostopoulos, Georgios, Doundoulakis, Ioannis, Antza, Christina, Bouras, Emmanouil, Nirantharakumar, Krishnarajah, Tsiachris, Dimitrios, Thomas, G Neil, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Toulis, Konstantinos A
(2021) Incident atrial fibrillation in patients with differentiated thyroid cancer: a meta-analysis. ENDOCRINE-RELATED CANCER, 28 (5). pp. 325-335.

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Abstract

Differentiated thyroid cancer (DTC) represents the most common form of thyroid neoplasms and is becoming increasingly prevalent. Evidence suggests a possible relationship between DTC diagnosis and subsequent atrial fibrillation (AF). If confirmed, this may present an alarming health risk (AF) in an otherwise condition with a relatively good prognosis (DTC). The aim of this systematic review and meta-analysis is to provide for the first time a pooled estimate of AF incidence in DTC patients in comparison to healthy controls. A detailed search in electronic databases, clinical trial registries and grey literature was performed to identify studies reporting the incidence of AF in DTC patients. Newcastle-Ottawa quality assessment scale was used to assess study quality. We used a random effects (RE) generalized linear mixed model (GLMM) in pooling of individual studies and also calculated a prediction interval for the estimate of a new study. Six observational studies met the eligibility criteria, which included totally 187,754 patients with DTC and 199,770 healthy controls. The median follow-up period was 4.3 to 18.8 years; the incidence rate of AF was 4.86 (95% CI, 3.29 to 7.17, I2 = 96%) cases per 1000 person-years, while the incidence rate ratio was 1.54 (95% CI, 1.44 to 1.65, I2 = 0%, 95% PI, 1.33 to 1.78).This is the first meta-analysis to confirm that patients with DTC are at a high risk for developing AF, which may be attributed to a state of iatrogenic hyperthyroidism due to long-term thyrotropin suppression therapy.

Item Type: Article
Uncontrolled Keywords: differentiated thyroid cancer, atrial fibrillation, systematic review, meta-analysis
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 15 Jun 2021 10:05
Last Modified: 18 Jan 2023 22:34
DOI: 10.1530/ERC-20-0496
Open Access URL: https://erc.bioscientifica.com/view/journals/erc/2...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3126430