Name:
Atrial Fibrillation Hypothyroidism Levothyroxine Replacement
Description:
Atrial Fibrillation Hypothyroidism Levothyroxine Replacement
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/74c93ee1-a944-4421-ae98-b72b1c2dc352/thumbnails/74c93ee1-a944-4421-ae98-b72b1c2dc352.jpeg?sv=2019-02-02&sr=c&sig=g6a8K8x6ImD05V%2FRZH0%2BNiqIC8Lng6UaFCOkwPJSYJM%3D&st=2024-12-22T06%3A12%3A06Z&se=2024-12-22T10%3A17%3A06Z&sp=r
Duration:
T00H03M49S
Embed URL:
https://stream.cadmore.media/player/74c93ee1-a944-4421-ae98-b72b1c2dc352
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/74c93ee1-a944-4421-ae98-b72b1c2dc352/18778972.mp3?sv=2019-02-02&sr=c&sig=2h7kkbDoDRoq%2F8fIlZC%2BExxaXcK7oMI8UYpZB%2Bw8%2BMQ%3D&st=2024-12-22T06%3A12%3A06Z&se=2024-12-22T08%3A17%3A06Z&sp=r
Upload Date:
2022-02-28T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
>> Practice Impact Extra podcasts are derived from Hurst's, The Heart Board Review, and other online resources available only through accesscardiology.com. >> Thyroid disease and associated cardiovascular disease presents challenges. What have we learned about treatment? [ Music ] Hi, Dr. Bernie here, and welcome to Practice Impact Extra. As is well-documented, the adult population in the United States is aging with more than 70 million people aged 60 and older.
Increase in age is associated with numerous health risks. The increased incidence of atrial fibrillation is strongly associated with age and clinical cardiovascular disease. Studies have documented the incidence of subclinical hypothyroidism increases with age and ranges between 3% to 16% in individuals aged 60 and older. Treatment with thyroid replacement medication represents a challenge in deciding who to treat, how to treat, and particularly as it relates to dosing and the side effect risk.
Contemporary data on the effect of the levothyroxine dose and the occurrence of atrial fibrillation or lacking particularly in the elderly. A study published in the American Heart Journal in October 2020 set out to determine the effect of cumulative levothyroxine exposure on the risk of atrial fibrillation. This population-based observational study utilized 190,000 healthcare databases from Ontario, Canada to identify adults 66 years of age and older who had no history of atrial fibrillation but did have at least one levothyroxine prescription filled between April of 2007 and March 31st of 2016.
Patients with an incidence atrial fibrillation were matched with five controls that did not have atrial fibrillation in the defined index period. The authors compared the outcomes between older patients who received levothyroxine high dose 0.125 milligrams a day, or a medium dose of .075 to 0.125 milligrams, or low dose of levothyroxine at .075 milligrams a day.
So what did they find? 16% of patients did go on to develop atrial fibrillation. Cumulative exposure of levothyroxine dose over 1 year was associated with a higher risk of incidence of atrial fibrillation in a dose response fashion. Among older patients, the risk of atrial fibrillation was found to begin increasing at an average dose .075 milligrams of levothyroxine daily, with the highest risk occurring in patients taking greater than .125 milligrams a day.
So what's the take home message? These findings highlight a need to consider more conservative doses with closer monitoring of levothyroxine in the elderly. Further research for treatment targeted in the elderly is strongly recommend. Thank you for joining me and see you next time on Practice Impact Extra. >> We hope you enjoyed this podcast from McGraw-Hill. Subscribers to AccessCardiology have instant access to over 25,000 pages of rich medical content, receive medical updates from trusted experts, and have access to other special features.
To subscribe or learn more, please visit accesscardiology.com.
