Fan Si Wei David, Ong Leong Tung
Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
touchREV Endocrinol. 2024 Oct;20(2):91-99. doi: 10.17925/EE.2024.20.2.12. Epub 2024 Jul 22.
Hyperthyroidism has a significant impact on the cardiovascular system, causing thyrotoxic cardiomyopathy, which is characterized by atrial fibrillation, left ventricular hypertrophy and diastolic dysfunction, and may lead to heart failure. This study aimed to investigate the prevalence and associated risk factors for heart failure in patients with hyperthyroidism. A systematic literature search was conducted on PubMed, SCOPUS and Ovid SP up until April 2023. Pooled prevalence and pooled odds ratio for risk factors were calculated using the generic inverse variance method. Studies involving 30,889 patients were included in this meta-analysis. The overall prevalence of heart failure in patients with hyperthyroidism was 8% (95% confidence interval [CI]: 6-11%). Further analyses revealed that the prevalence of heart failure in patients who underwent treatment with radioactive iodine ablation, antithyroid medication and thyroidectomy was 8% (95% CI: -1 to 16%), 6% (95% CI: 2 to 11%) and 4% (95% CI: -2 to 10%), respectively. The risk factors of heart failure in hyperthyroidism include atrial fibrillation, chronic kidney disease, anaemia, hypertension, history of stroke or transient ischaemic attack, history of coronary artery disease and diabetes mellitus. Heart failure occurs in 8% of patients with hyperthyroidism, with the most common risk factor being atrial fibrillation.
甲状腺功能亢进对心血管系统有显著影响，可导致甲状腺毒症性心肌病，其特征为心房颤动、左心室肥厚和舒张功能障碍，并可能导致心力衰竭。本研究旨在调查甲状腺功能亢进患者心力衰竭的患病率及相关危险因素。截至2023年4月，在PubMed、SCOPUS和Ovid SP上进行了系统的文献检索。使用通用逆方差法计算危险因素的合并患病率和合并比值比。本荟萃分析纳入了涉及30889例患者的研究。甲状腺功能亢进患者心力衰竭的总体患病率为8%（95%置信区间[CI]：6-11%）。进一步分析显示，接受放射性碘消融、抗甲状腺药物和甲状腺切除术治疗的患者心力衰竭患病率分别为8%（95%CI：-1至16%）、6%（95%CI：2至11%）和4%（95%CI：-2至10%）。甲状腺功能亢进患者心力衰竭的危险因素包括心房颤动、慢性肾脏病、贫血、高血压、中风或短暂性脑缺血发作史、冠状动脉疾病史和糖尿病。8%的甲状腺功能亢进患者会发生心力衰竭，最常见的危险因素是心房颤动。
