Association between thyroid cancer and cardiovascular disease risk: a nationwide observation study
Abstract Treatment with levothyroxine and radioiodine contribute alternative cardiovascular function in adults with thyroid cancer. The risks of long-term cardiovascular conditions among thyroid cancer patients is unknown. This study aimed to compare the incidence of coronary heart disease (CHD), is...
Main Authors: | , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Nature Portfolio
2022-11-01
|
Series: | Scientific Reports |
Online Access: | https://doi.org/10.1038/s41598-022-22462-z |
_version_ | 1811329020701179904 |
---|---|
author | Ming-Chieh Tsai Cheng-Tzu Hsieh Hsin-Yin Hsu Tzu-Lin Yeh Wen-Chung Lee Chun-Ju Chiang Bo-Yu Hsiao Jing-Rong Jhuang Wen-Hsuan Tsai Shih-Ping Cheng Chao-Liang Chou Chun-Chuan Lee Sung-Chen Liu Po-Jung Tseng Kuo-Liong Chien |
author_facet | Ming-Chieh Tsai Cheng-Tzu Hsieh Hsin-Yin Hsu Tzu-Lin Yeh Wen-Chung Lee Chun-Ju Chiang Bo-Yu Hsiao Jing-Rong Jhuang Wen-Hsuan Tsai Shih-Ping Cheng Chao-Liang Chou Chun-Chuan Lee Sung-Chen Liu Po-Jung Tseng Kuo-Liong Chien |
author_sort | Ming-Chieh Tsai |
collection | DOAJ |
description | Abstract Treatment with levothyroxine and radioiodine contribute alternative cardiovascular function in adults with thyroid cancer. The risks of long-term cardiovascular conditions among thyroid cancer patients is unknown. This study aimed to compare the incidence of coronary heart disease (CHD), ischemic stroke (IS), and atrial fibrillation (AF) among adults with thyroid cancer with that of the general population, especially when stratified by age (< 65 and ≥ 65 years old). This observational cohort study enrolled patients between January 1, 2011 and December 31, 2016 with a follow-up until December 31, 2018. This study analyzed the data of Taiwanese thyroid cancer patients registered on the National Taiwan Cancer Registry Database, with CHD and IS. SIR models were used to evaluate the association between thyroid cancer and CHD, IS, AF, and cardiovascular disease outcome, stratified by age and sex. SIR analyses were also conducted for both sexes, age groups (< 65, ≥ 65 years), and different follow-up years. After excluding 128 individuals (< 20 years or ≥ 85 years old) and with missing index data, 4274 eligible thyroid cancer patients without CHD history, 4343 patients without IS history, and 4247 patients without AF history were included for analysis. During the median follow-up of 3.5 (1.2) years among thyroid cancer patients, the observed number of new CHD events was 70; IS, 30; and AF, 20, respectively. The SIR was significantly higher for CHD (SIR, 1.57; 95% confidence interval [CI] 1.2–1.93) among thyroid cancer patients compared with the age- and sex-specific standardized population. However, the association between thyroid cancer and the risks of IS (SIR, 0.74; 95% CI 0.47–1), cardiovascular disease (SIR, 0.88; 95% CI 0.7–1.05), and atrial fibrillation (SIR, 0.74; 95% CI 0.42–1.06) were insignificant. Moreover, stratification by age < 65 or age ≥ 65 years old and by sex for CHD suggested that the diagnosis of thyroid cancer in the young may attenuate the CHD risk (SIR, 2.08; 95% CI 1.5–2.66), and the CVD risk was constant among both men (SIR, 1.63; 95% CI 1.03–2.24) and women (SIR, 1.53; 95% CI 1.06–1.99). The patients had persistent higher CHD risk for 5 years after cancer diagnosis. Thyroid cancer survivors have a substantial CHD risk, even at long-term follow-up, especially in those patients < 65 years old. Further research on the association between thyroid cancer and CHD risk is warranted. |
first_indexed | 2024-04-13T15:36:25Z |
format | Article |
id | doaj.art-39e5be113b7a41fbb8c89b20eeb80e61 |
institution | Directory Open Access Journal |
issn | 2045-2322 |
language | English |
last_indexed | 2024-04-13T15:36:25Z |
publishDate | 2022-11-01 |
publisher | Nature Portfolio |
record_format | Article |
series | Scientific Reports |
spelling | doaj.art-39e5be113b7a41fbb8c89b20eeb80e612022-12-22T02:41:15ZengNature PortfolioScientific Reports2045-23222022-11-011211810.1038/s41598-022-22462-zAssociation between thyroid cancer and cardiovascular disease risk: a nationwide observation studyMing-Chieh Tsai0Cheng-Tzu Hsieh1Hsin-Yin Hsu2Tzu-Lin Yeh3Wen-Chung Lee4Chun-Ju Chiang5Bo-Yu Hsiao6Jing-Rong Jhuang7Wen-Hsuan Tsai8Shih-Ping Cheng9Chao-Liang Chou10Chun-Chuan Lee11Sung-Chen Liu12Po-Jung Tseng13Kuo-Liong Chien14Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan UniversityDepartment of Epidemiology, University of CaliforniaInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan UniversityInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan UniversityInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan UniversityInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan UniversityInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan UniversityInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan UniversityDivision of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Mackay Memorial HospitalDivision of General Surgery, Department of Surgery, Taipei Mackay Memorial HospitalDepartment of Neurology, Taipei Mackay Memorial HospitalDivision of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Mackay Memorial HospitalDivision of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Mackay Memorial HospitalDivision of Cardiovascular Surgery, Department of Surgery, Hsin Chu Armed Force HospitalInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan UniversityAbstract Treatment with levothyroxine and radioiodine contribute alternative cardiovascular function in adults with thyroid cancer. The risks of long-term cardiovascular conditions among thyroid cancer patients is unknown. This study aimed to compare the incidence of coronary heart disease (CHD), ischemic stroke (IS), and atrial fibrillation (AF) among adults with thyroid cancer with that of the general population, especially when stratified by age (< 65 and ≥ 65 years old). This observational cohort study enrolled patients between January 1, 2011 and December 31, 2016 with a follow-up until December 31, 2018. This study analyzed the data of Taiwanese thyroid cancer patients registered on the National Taiwan Cancer Registry Database, with CHD and IS. SIR models were used to evaluate the association between thyroid cancer and CHD, IS, AF, and cardiovascular disease outcome, stratified by age and sex. SIR analyses were also conducted for both sexes, age groups (< 65, ≥ 65 years), and different follow-up years. After excluding 128 individuals (< 20 years or ≥ 85 years old) and with missing index data, 4274 eligible thyroid cancer patients without CHD history, 4343 patients without IS history, and 4247 patients without AF history were included for analysis. During the median follow-up of 3.5 (1.2) years among thyroid cancer patients, the observed number of new CHD events was 70; IS, 30; and AF, 20, respectively. The SIR was significantly higher for CHD (SIR, 1.57; 95% confidence interval [CI] 1.2–1.93) among thyroid cancer patients compared with the age- and sex-specific standardized population. However, the association between thyroid cancer and the risks of IS (SIR, 0.74; 95% CI 0.47–1), cardiovascular disease (SIR, 0.88; 95% CI 0.7–1.05), and atrial fibrillation (SIR, 0.74; 95% CI 0.42–1.06) were insignificant. Moreover, stratification by age < 65 or age ≥ 65 years old and by sex for CHD suggested that the diagnosis of thyroid cancer in the young may attenuate the CHD risk (SIR, 2.08; 95% CI 1.5–2.66), and the CVD risk was constant among both men (SIR, 1.63; 95% CI 1.03–2.24) and women (SIR, 1.53; 95% CI 1.06–1.99). The patients had persistent higher CHD risk for 5 years after cancer diagnosis. Thyroid cancer survivors have a substantial CHD risk, even at long-term follow-up, especially in those patients < 65 years old. Further research on the association between thyroid cancer and CHD risk is warranted.https://doi.org/10.1038/s41598-022-22462-z |
spellingShingle | Ming-Chieh Tsai Cheng-Tzu Hsieh Hsin-Yin Hsu Tzu-Lin Yeh Wen-Chung Lee Chun-Ju Chiang Bo-Yu Hsiao Jing-Rong Jhuang Wen-Hsuan Tsai Shih-Ping Cheng Chao-Liang Chou Chun-Chuan Lee Sung-Chen Liu Po-Jung Tseng Kuo-Liong Chien Association between thyroid cancer and cardiovascular disease risk: a nationwide observation study Scientific Reports |
title | Association between thyroid cancer and cardiovascular disease risk: a nationwide observation study |
title_full | Association between thyroid cancer and cardiovascular disease risk: a nationwide observation study |
title_fullStr | Association between thyroid cancer and cardiovascular disease risk: a nationwide observation study |
title_full_unstemmed | Association between thyroid cancer and cardiovascular disease risk: a nationwide observation study |
title_short | Association between thyroid cancer and cardiovascular disease risk: a nationwide observation study |
title_sort | association between thyroid cancer and cardiovascular disease risk a nationwide observation study |
url | https://doi.org/10.1038/s41598-022-22462-z |
work_keys_str_mv | AT mingchiehtsai associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT chengtzuhsieh associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT hsinyinhsu associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT tzulinyeh associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT wenchunglee associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT chunjuchiang associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT boyuhsiao associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT jingrongjhuang associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT wenhsuantsai associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT shihpingcheng associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT chaoliangchou associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT chunchuanlee associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT sungchenliu associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT pojungtseng associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy AT kuoliongchien associationbetweenthyroidcancerandcardiovasculardiseaseriskanationwideobservationstudy |