The relationship between history of thyroid diseases and risk of in-hospital cardiovascular outcomes in patients with atrial fibrillation: Findings From the CCC-AF (Improving Care for Cardiovascular Disease in China-Atrial Fibrillation) Project

Background: Atrial fibrillation (AF) has the close relation to thyroid dysfunction and these two diseases lead to poor cardiovascular outcomes. But the prognostic value of thyroid diseases in AF remains unclear. We aimed to determine whether history of thyroid diseases is associated with risk of in-hospital cardiovascular outcomes in AF.MethodsBased on the data from the CCC-AF (Improving Care for Cardiovascular Diseases in China-Atrial Fibrillation) project, 31,486 inpatients with a definitive diagnosis of AF and record of history of thyroid diseases were included. Logistic regression analysis was performed to investigate the relationship between history of thyroid diseases and risk of in-hospital major adverse cardiovascular events (MACE) in AF.ResultsAmong AF patients, 503 (1.6%) had a history of hypothyroidism, 642 (2.0%) had a history of hyperthyroidism and 30,341 (96.4%) had no thyroid dysfunction. During this hospitalization, 5146 (16.3%) AF patients suffered from MACE. The incidence was 13.1% in hypothyroidism, 16.3% in euthyroidism and 19.0% in hyperthyroidism, in which there was a significant difference among three groups (p=0.028). Multivariable logistic regression analysis revealed that history of hypothyroidism decreased but history of hyperthyroidism increased the risk of in-hospital MACE in AF patients (adjusted odds ratio [OR]=0.603; 95% confidence interval [CI], 0.449–0.811; p=0.001 versus adjusted OR=1.327; 95% CI, 1.060–1.661; p=0.013).ConclusionHistory of hypothyroidism was an independent protective factor, whereas history of hyperthyroidism was an independent risk factor for in-hospital cardiovascular outcomes in AF. Our study indicated that hyperthyroidism should be treated aggressively in order to improve the prognosis of AF. (AU)

Antecedentes: La fibrilación auricular (FA) está estrechamente relacionada con la disfunción tiroidea, y estas 2 enfermedades conducen a resultados cardiovasculares deficientes. Pero el valor pronóstico de las enfermedades tiroideas en la FA sigue sin estar claro. Nuestro objetivo era determinar si la historia de enfermedades tiroideas está asociada con el riesgo de resultados cardiovasculares intrahospitalarios en la FA.MétodosEn base a los datos del proyecto de mejora de la atención de las enfermedades cardiovasculares en China - fibrilación auricular (CCC-FA, por sus siglas en inglés), se incluyeron 31.486 pacientes hospitalizados con un diagnóstico definitivo de FA y un registro de antecedentes de enfermedades tiroideas. Se realizó un análisis de regresión logística para investigar la relación entre la historia de las enfermedades tiroideas y el riesgo de eventos cardiovasculares adversos importantes intrahospitalarios (MACE) en FA.ResultadosEntre los pacientes con FA, 503 (1,6%) tenían antecedentes de hipotiroidismo, 642 (2,0%) antecedentes de hipertiroidismo y 30.341 (96,4%) no tenía disfunción tiroidea. Durante esta hospitalización, 5.146 (16,3%) pacientes con FA sufrieron de MACE. La incidencia fue del 13,1% en hipotiroidismo, del 16,3% en eutiroidismo y del 19,0% en hipertiroidismo, en los que hubo una diferencia significativa entre 3 grupos (p=0,028). El análisis de regresión logística multivariable reveló que la historia de hipotiroidismo disminuyó, pero la historia de hipertiroidismo aumentó el riesgo de MACE intrahospitalario en pacientes con FA (relación de probabilidades ajustadas [OR]: 0,603; intervalo de confianza [IC] del 95%: 0,449-0,811; p=0,001 frente a OR ajustado 1,327; IC del 95%: 1,060-1,661; p=0,013). (AU)

The relationship between history of thyroid diseases and risk of in-hospital cardiovascular outcomes in patients with atrial fibrillation: Findings From the CCC-AF (Improving Care for Cardiovascular Disease in China-Atrial Fibrillation) Project.

BACKGROUND: Atrial fibrillation (AF) has the close relation to thyroid dysfunction and these two diseases lead to poor cardiovascular outcomes. But the prognostic value of thyroid diseases in AF remains unclear. We aimed to determine whether history of thyroid diseases is associated with risk of in-hospital cardiovascular outcomes in AF. METHODS: Based on the data from the CCC-AF (Improving Care for Cardiovascular Diseases in China-Atrial Fibrillation) project, 31,486 inpatients with a definitive diagnosis of AF and record of history of thyroid diseases were included. Logistic regression analysis was performed to investigate the relationship between history of thyroid diseases and risk of in-hospital major adverse cardiovascular events (MACE) in AF. RESULTS: Among AF patients, 503 (1.6%) had a history of hypothyroidism, 642 (2.0%) had a history of hyperthyroidism and 30,341 (96.4%) had no thyroid dysfunction. During this hospitalization, 5146 (16.3%) AF patients suffered from MACE. The incidence was 13.1% in hypothyroidism, 16.3% in euthyroidism and 19.0% in hyperthyroidism, in which there was a significant difference among three groups (p=0.028). Multivariable logistic regression analysis revealed that history of hypothyroidism decreased but history of hyperthyroidism increased the risk of in-hospital MACE in AF patients (adjusted odds ratio [OR]=0.603; 95% confidence interval [CI], 0.449-0.811; p=0.001 versus adjusted OR=1.327; 95% CI, 1.060-1.661; p=0.013). CONCLUSION: History of hypothyroidism was an independent protective factor, whereas history of hyperthyroidism was an independent risk factor for in-hospital cardiovascular outcomes in AF. Our study indicated that hyperthyroidism should be treated aggressively in order to improve the prognosis of AF.

[Mechanism of As(2)O(3) on hdpr1 gene demethylation in Jurkat cell line].

This study was purposed to investigate the effect of As(2)O(3) on the demethylation of anti-oncogene-hdpr1 gene of acute lymphoblastic leukemia cell line Jurkat in vitro and its mechanism. The inhibitory effect of As(2)O(3) on the proliferation of Jurkat cells was assayed by CCK-8; the change of Jurkat cell cycle was detected by flow cytometry before and after using As(2)O(3); the effect of As(2)O(3) on the methylation model of hdpr1 gene was analyzed by methylation-specific PCR, and the effect of As(2)O(3) on the expression of hdpr1 mRNA was analyzed by semiquantitative RT-PCR. The results showed that the proliferation rate of Jurkat cells was decreased significantly after being treated with As(2)O(3), and in dose-and time-dependent manner; As(2)O(3) blocked Jurkat cell cycle in G(0)/G(1) phase in dose-dependent manner. As(2)O(3) could reverse hypermethylation of hdpr1 gene and induce its mRNA reexpression, and down-regulate the dnmt1, dnmt3a, dnmt3b mRNA expression level also in dose-dependent manner. It is concluded that the As(2)O(3) suppresses the proliferation of Jurkat cells and blocks cell cycle is G(0)/G(1), its possible mechanism may be down-regulating mRNA expression level of dnmt1, dnmt3a and dnmt3b, induce demethylation of hdpr1 gene from abnormal hypermethylation status and activates its reexpression.