Department of Endocrinology and Nutrition, University Hospital Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Madrid, Spain.
Departament of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
Endocrine. 2024 Feb;83(2):405-413. doi: 10.1007/s12020-023-03482-9. Epub 2023 Aug 15.
The cardiovascular (CV) system is profoundly affected by thyroid hormones. Both hypo- and hyperthyroidism can increase the risk of severe CV complications.
To assess the association of hyperthyroidism with major CV risk factors (CVRFs) and CV diseases (CVDs) using a big data methodology with the Savana Manager platform.
This was an observational and retrospective study. The data were obtained from the electronic medical records of the University Hospital Puerta de Hierro Majadahonda (Spain). Artificial intelligence techniques were used to extract the information from the electronic health records and Savana Manager 3.0 software was used for analysis.
Of a total of 540,939 patients studied (53.62% females; mean age 42.2 ± 8.7 years), 5504 patients (1.02%; 69.9% women) had a diagnosis of hyperthyroidism. Patients with this diagnosis had a significantly (p < 0.0001) higher frequency of CVRFs than that found in non-hyperthyroid subjects. The higher frequency of CVRFs in patients with hyperthyroidism was observed in both women and men and in patients younger and older than 65 years of age. The total frequency of CVDs was also significantly (p < 0.0001) higher in patients diagnosed with hyperthyroidism than that found in patients without this diagnosis. The highest odds ratio values obtained were 6.40 (4.27-9.61) for embolic stroke followed by 5.99 (5.62-6.38) for atrial fibrillation. The frequency of all CVDs evaluated in patients with a diagnosis of hyperthyroidism was significantly higher in both women and men, as well as in those younger and older than 65 years, compared to subjects without this diagnosis. A multivariate regression analysis showed that hyperthyroidism was significantly and independently associated with all the CVDs evaluated except for embolic stroke.
The data from this hospital cohort suggest that there is a significant association between the diagnosis of hyperthyroidism and the main CVRFs and CVDs in our population, regardless of the age and gender of the patients. Our study, in addition to confirming this association, provides useful information for understanding the applicability of artificial intelligence techniques to "real-world data and information".
甲状腺激素对心血管系统有深远的影响。无论是甲状腺功能减退还是甲状腺功能亢进都可能增加严重心血管并发症的风险。
使用 Savana Manager 平台的大数据方法评估甲状腺功能亢进与主要心血管危险因素（CVRF）和心血管疾病（CVD）之间的关联。
这是一项观察性和回顾性研究。数据来自西班牙 Puerta de Hierro Majadahonda 大学医院的电子病历。使用人工智能技术从电子健康记录中提取信息，并使用 Savana Manager 3.0 软件进行分析。
在研究的 540939 名患者中（53.62%为女性；平均年龄 42.2±8.7 岁），5504 名患者（1.02%；69.9%为女性）被诊断为甲状腺功能亢进。患有这种疾病的患者的 CVRF 频率明显（p<0.0001）高于非甲状腺功能亢进患者。在女性和男性以及 65 岁以上和以下的患者中，甲状腺功能亢进患者的 CVRF 频率更高。与未诊断出甲状腺功能亢进的患者相比，诊断出甲状腺功能亢进的患者的 CVD 总频率也明显（p<0.0001）更高。获得的最高比值比（OR）值为 6.40（4.27-9.61），用于栓塞性中风，其次是心房颤动的 5.99（5.62-6.38）。与未诊断出甲状腺功能亢进的患者相比，患有甲状腺功能亢进的患者的所有 CVD 评估频率在女性和男性以及 65 岁以上和以下的患者中均明显更高。多变量回归分析显示，甲状腺功能亢进与评估的所有 CVD 均显著且独立相关，除栓塞性中风外。
来自该医院队列的数据表明，在我们的人群中，甲状腺功能亢进的诊断与主要 CVRF 和 CVD 之间存在显著关联，与患者的年龄和性别无关。我们的研究除了证实这种关联外，还为理解人工智能技术在“真实世界数据和信息”中的适用性提供了有用信息。
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