TSH-suppressive therapy and the increased risk of cardiovascular disease in patients with differentiated thyroid cancer (DTC) was previously reported. A recent study by Pajamäki and colleagues found that patients with DTC have a higher risk of atrial fibrillation but a lower all-cause cardiovascular death rate. This study offers insights into this effect.
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References
Haugen, B. R. et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26, 1–133 (2016).
Diessl, S. et al. Impact of moderate versus stringent TSH suppression on survival in advanced differentiated thyroid carcinoma. Clin. Endocrinol. 76, 586–592 (2012).
Carhill, A. A. et al. Long-term outcomes following therapy in differentiated thyroid carcinoma: NTCTCS registry analysis 1987–2012. J. Clin. Endocrinol. Metab. 100, 3270–3279 (2015).
Hovens, G. C. et al. Associations of serum thyrotropin concentrations with recurrence and death in differentiated thyroid cancer. J. Clin. Endocrinol. Metab. 92, 2610–2615 (2007).
Selmer, C. et al. The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study. BMJ 345, e7895 (2012).
Verburg, F. A. et al. Changes within the thyroid axis after long-term TSH-suppressive levothyroxine therapy. Clin. Endocrinol. 76, 577–581 (2012).
Verburg, F. A. et al. The thyroid axis 'setpoints' are significantly altered after long-term suppressive LT4 therapy. Horm. Metab. Res. 46, 794–799 (2014).
Pajamaki, N. et al. Long-term cardiovascular morbidity and mortality in patients treated for differentiated thyroid cancer. Clin. Endocrinol. https://doi.org/10.1111/cen.13519 (2017).
Verburg, F. A. et al. Life expectancy is reduced in differentiated thyroid cancer patients ≥45 years old with extensive local tumor invasion, lateral lymph node, or distant metastases at diagnosis and normal in all other DTC patients. J. Clin. Endocrinol. Metab. 98, 172–180 (2013).
Abdulrahman, R. M. et al. Both exogenous subclinical hyperthyroidism and short-term overt hypothyroidism affect myocardial strain in patients with differentiated thyroid carcinoma. Thyroid 21, 471–476 (2011).
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M.L. declares that he is a consultant for AstraZeneca, Bayer Healthcare, Sanofi Genzyme and Sobi and has received speaker honoraria and research support from Sanofi Genzyme, Henning and Merck. F.A.V. declares that he is a consultant for Sanofi Genzyme and has received speaker honoraria from Diasorin and Sanofi Genzyme.
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Verburg, F., Luster, M. Balancing benefit and risk in TSH management of DTC. Nat Rev Endocrinol 14, 136–137 (2018). https://doi.org/10.1038/nrendo.2018.1
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DOI: https://doi.org/10.1038/nrendo.2018.1
