Higher Burden of Comorbidities in Patients With Atrial Fibrillation and Thyroid Disease

Among patients with atrial fibrillation, those with thyroid disease had distinct baseline features compared with their counterparts. These findings, as determined from a study conducted by researchers in Jordan, were published in the Annals of Medicine and Surgery.

This retrospective analysis sourced data from the Jordanian Atrial Fibrillation Study (JpFib), which was a prospective, observational, multicenter study performed at 19 hospitals and 30 outpatient clinics in Jordan and one hospital in Palestine between 2019 and 2020. Baseline characteristics were compared between patients with thyroid disease (n=210) and those without thyroid disease (n=1790).

The patient population consisted of 53.3% men; mean age was 67.6±13.1 years, 74.3% had hypertension, 44.1% had diabetes mellitus, 43.9% had dyslipidemia, 13.7% were current smokers, 63.6% had nonparoxysmal atrial fibrillation, and 91.2% nonvalvular atrial fibrillation.

Patients with thyroid disease were older (P =.007) and more were women (P <.01).  Compared with those without thyroid disease, patients with thyroid disease had pulmonary hypertension (P =.017), chronic kidney disease (P =.015), diabetes (P =.040), presented with shortness of breath (P =.020), reported fatigue (P =.005), were current smokers (P =.025), or had comorbid coronary artery disease (P =.028). Fewer patients with thyroid disease were reported to use antiplatelet agents (P =.019),

Patients with thyroid disease did not have differing risk factors for stroke or bleeding.

Stratified by thyroid status, patients who were hypothyroid (n=190), hyperthyroid (n=13), and euthyroid (n=7) had relatively similar baseline characteristics. The only difference among all 3 groups was that more women had hypothyroidism than men, but sexes were evenly split among the hyperthyroidism and euthyroid groups (P =.029).

This study was limited by not evaluating outcomes associated with atrial fibrillation or thyroid disease.

The study authors concluded, “Our analysis demonstrated a thyroid disease prevalence rate of 10.5% in patients with [atrial fibrillation], of which 90.0% were hypothyroid, 6.1% were hyperthyroid, and 3.3% were euthyroid. Despite having similar risks of stroke and major bleeding, patients with thyroid disease had significantly higher rates of comorbidities and usage of anticoagulants. Further prospective studies should be conducted in order to assess the impact of thyroid disease on treatment outcomes.”

Reference

Al-Makhamreh H, Al-Ani A, Alkhulaifat D, et al. Impact of thyroid disease in patients with atrial fibrillation: Analysis from the JoFib registry. Ann Med Surg. 2022;74:103325. doi:10.1016/j.amsu.2022.103325