- A retrospective study from the United Kingdom suggests that hyperthyroidism, indicated by low levels of thyroid-stimulated hormone (TSH), is associated with reduced survival of patients with Graves' disease, independent of treatment method.
Why this matters
- The relative benefits of treatment modality and interactions with thyroid status are unclear.
- Patients with Graves' disease experienced increased all-cause mortality (aHR, 1.23; P=.033) and major adverse cardiovascular events (MACEs; aHR, 2.47; P<.0001 compared with control subjects.>
- Patients treated with radioiodine with resolved hyperthyroidism had reduced mortality (HR, 0.50; P=.012) and MACE risk (HR, 0.59; P=.021) compared with patients treated with antithyroid drugs.
- Patients treated with radioiodine with unresolved hyperthyroidism had similar mortality (HR, 1.51; P=.079) but increased MACE risk (HR, 1.52; P=.042) compared with patients treated with antithyroid drugs.
- In all patients with Graves' disease, persistently low TSH concentrations 1 year after diagnosis were associated with increased mortality (HR, 1.55; P=.019) and MACEs (HR, 1.54; P=.020).
- 4189 patients with Graves' disease and 16,756 control subjects were analyzed for associations between treatment type, thyroid status, and mortality/MACE risk.
- Funding: National Institute of Social Care and Health Research.
- Retrospective analysis of large database.