Thyroid replacement therapy, thyroid stimulating hormone concentrations, and long term health outcomes in patients with hypothyroidism: longitudinal study.
Rasiah ThayakaranNicola J AdderleyChristopher SainsburyBarbara TorlinskaKristien BoelaertDana ŠumiloMalcolm PriceG Neil ThomasKonstantinos A ToulisKrishnarajah NirantharakumarPublished in: BMJ (Clinical research ed.) (2019)
In patients with a diagnosis of hypothyroidism, no evidence was found to suggest a clinically meaningful difference in the pattern of long term health outcomes (all cause mortality, atrial fibrillation, ischaemic heart disease, heart failure, stroke/transient ischaemic attack, fractures) when TSH concentrations were within recommended normal limits. Evidence was found for adverse health outcomes when TSH concentration is outside this range, particularly above the upper reference value.
Keyphrases
- replacement therapy
- atrial fibrillation
- heart failure
- smoking cessation
- left atrial
- catheter ablation
- oral anticoagulants
- left atrial appendage
- cerebral ischemia
- direct oral anticoagulants
- pulmonary hypertension
- left ventricular
- emergency department
- acute coronary syndrome
- coronary artery disease
- blood brain barrier
- drug induced