The incidence of venous thromboembolism in patients with overt hyperthyroidism

Ruud S. Kootte; Danka J. F. Stuijver; Olaf M. Dekkers; Bregje van Zaane; Eric Fliers; Suzanne C. Cannegieter; Victor E. A. Gerdes

doi:10.1160/TH11-10-0691

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2012; 107(03): 417-422
DOI: 10.1160/TH11-10-0691

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

The incidence of venous thromboembolism in patients with overt hyperthyroidism

A retrospective multicentre cohort study

Ruud S. Kootte

¹Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands

²Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

,

Danka J. F. Stuijver

¹Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands

²Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

,

Olaf M. Dekkers

³Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands

⁴Department of Clinical Epidemiology, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands

,

Bregje van Zaane

¹Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands

²Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

,

Eric Fliers

⁵Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

,

Suzanne C. Cannegieter

⁴Department of Clinical Epidemiology, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands

,

Victor E. A. Gerdes

¹Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands

²Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

› Institutsangaben

Abstract

Summary

Hyperthyroidism is associated with several changes in the haemostatic system resulting in a hypercoagulable state. It is uncertain at this stage whether this leads to an increased risk of venous thromboembolism (VTE). The aim of this retrospective cohort study was to determine the risk of VTE in all patients with overt hyperthyroidism and to compare this to the risk of VTE in the general population. In three hospitals in the Netherlands, patients with biochemically confirmed hyperthyroidism caused by Graves’ disease, multinodular goiter or toxic adenoma were included. All available electronic and handwritten records were examined. Primary outcome was the occurrence of VTE within six months before and until six months after the diagnosis of hyperthyroidism. We included a total of 587 patients. Five patients experienced a VTE during the study period, resulting in an incidence rate of 8.7 (95% CI 2.8 – 20.2) per 1,000 person-years. Three of these five patients had a first VTE (incidence rate for first VTE was 5.3 [95% CI 1.1 – 15.6] per 1,000 person-years). Incidence rates of VTE in the general population are between 0.6 and 1.6 per 1,000 person-years for first VTE and 0.7 and 1.8 per 1,000 person-years for all VTE. In conclusion, the incidence rate of VTE in patients with hyperthyroidism appears to be high. Future prospective studies are needed to further explore this possible association and to address its clinical implications.

Keywords

Hyperthyroidism - epidemiology - risk factor - venous thromboembolism

Volltext

Referenzen

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