Thyrotrophin levels and coronary artery calcification: Cross‐sectional results of the Brazilian Longitudinal Study of Adult Health (<scp>ELSA</scp>‐Brasil)

Miranda, Érique José Farias Peixoto de; Bittencourt, Márcio Sommer; Staniak, Henrique Lane; Pereira, Alexandre C.; Foppa, Murilo; Santos, Itamar de Souza; Lotufo, Paulo A

doi:10.1111/cen.13393

Cited by 14 publications

(15 citation statements)

References 32 publications

(56 reference statements)

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“…The measurement of the CAC score was calculated using a threshold of 130 Hounsfield units and expressed in Agatston units . CAC severity was further categorized with a cutoff at 100 points because it is a better marker of worse prognosis than CAC >0 …”

Section: Methodsmentioning

confidence: 99%

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Coffee Consumption and Coronary Artery Calcium Score: Cross‐Sectional Results of ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health)

Miranda

Steluti

Goulart

et al. 2018

JAHA

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BackgroundAvailable evidence for the relationship between coffee intake and subclinical atherosclerosis is limited and inconsistent. This study aimed to evaluate the association between coffee consumption and coronary artery calcium (CAC) in ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health).Methods and ResultsThis cross‐sectional study is based on baseline data from participants of the ELSA‐Brasil cohort. Only participants living in São Paulo, Brazil, who underwent a CAC measurement (n=4426) were included. Coffee consumption was collected using a food frequency questionnaire. CAC was detected with computed tomography and expressed as Agatston units. CAC was further categorized as an Agatson score ≥100 (CAC ≥100). In multiple logistic regression analysis considering intake of coffee and smoking status interaction, significant inverse associations were observed between coffee consumption (>3 cups/d) and CAC≥100 (odds ratio [OR]: 0.85 [95% confidence interval, 0.58–1.24] for ≤1 cup/d; OR: 0.73 [95% confidence interval, 0.51–1.05] for 1–3 cups/d; OR: 0.33 [95% confidence interval, 0.17–0.65] for >3 cups/d). Moreover, there was a statistically significant interaction effect for coffee consumption and smoking status (P=0.028 for interaction). After stratification by smoking status, the analysis revealed a lower OR of coronary calcification in never smokers drinking >3 cups/d (OR: 0.37 [95% confidence interval, 0.15–0.91]), whereas among current and former smokers, the intake of coffee was not significantly associated with coronary calcification.ConclusionsHabitual consumption of >3 cups/d of coffee decreased odds of subclinical atherosclerosis among never smokers. The consumption of coffee could exert a potential beneficial effect against coronary calcification, particularly in nonsmokers.

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Section: Methodsmentioning

confidence: 99%

“…30 CAC severity was further categorized with a cutoff at 100 points because it is a better marker of worse prognosis than CAC >0. [31][32][33]…”

Section: Cac Measurementmentioning

confidence: 99%

Coffee Consumption and Coronary Artery Calcium Score: Cross‐Sectional Results of ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health)

Miranda

Steluti

Goulart

et al. 2018

JAHA

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“…In addition, the CACS is a predictor of the occurrence of cardiovascular events even in asymptomatic patients with-out classical risk factors [6]. Some studies have evaluated the association between SCH and high CACS [7][8][9][10]. Whereas an association has been demonstrated in patients with intermediate or high cardiovascular risk [7,8], the data for low-risk patients are conflicting [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have evaluated the association between SCH and high CACS [7][8][9][10]. Whereas an association has been demonstrated in patients with intermediate or high cardiovascular risk [7,8], the data for low-risk patients are conflicting [8][9][10]. Accordingly, current guidelines suggest levothyroxine (L-T4) therapy of SCH with TSH ≤ 10 mIU/l based on cardiovascular risk only in patients less than 65-70 years of age who are at moderate/high risk, such as patients with dyslipidemia or diabetes mellitus [2,3,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Subclinical Hypothyroidism with TSH>7 mIU/l and≤10 mIU/l and Coronary Artery Disease

Rosário

Calsolari

2020

Horm Metab Res

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The association of subclinical hypothyroidism (SCH) with increased cardiovascular risk is controversial when thyroid-stimulating hormone (TSH) concentration is<10 mIU/l, as well as its association with a higher coronary artery calcium score (CACS) in individuals with low cardiovascular risk. This study evaluated coronary artery disease (CAD) by CACS in asymptomatic, low-cardiovascular risk women with SCH and TSH>7 mIU/l and≤10 mIU/l untreated for 5 years after diagnosis. The CACS was obtained for two groups of women with low cardiovascular risk. Group A consisted of 32 women with mild SCH (TSH>7 mIU/l and≤10 mIU/l) who remained untreated for 5 years, and group B consisted of 32 euthyroid women matched for age and body mass index to group A. The CACS ranged from 0 to 350 (median 0, 25–75% interval: 0–10) in group A and from 0 to 280 (median 0, 25–75% interval: 0–0) in group B. Scores>0 and≥10 were significantly more frequent in group A (40.6 vs. 12.5% and 25 vs. 3.1%, respectively). A CACS≥100 was also more frequent in group A (18.75 vs. 3.1%), but the difference was not significant (p=0.1). The results of the study suggest that long-term SCH with TSH>7 mIU/l and ≤ 10 mIU/l is associated with a higher risk of CAD in individuals≤65 years, even in those with low cardiovascular risk.

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“…Subclinical hyperthyroidism has been linked to atrial fibrillation and coronary artery calcification, whereas subclinical hypothyroidism has been associated with hypercholesterolemia and atherosclerosis (1,2). Despite these observations, data from large prospective cohorts regarding thyroid function and cardiovascular events and mortality are conflicting (3,4).…”

Section: Introductionmentioning

confidence: 99%

The kidney, subclinical thyroid disease and cardiovascular outcomes in older patients

Zijlstra

Velzen

Şimşek

et al. 2020

Endocrine Connections

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Objective Thyroid hormones have been implicated to play a role in cardiovascular disease, along with studies linking thyroid hormone to kidney function. The aim of this study is to investigate whether kidney function modifies the association of subclinical thyroid dysfunction and the risk of cardiovascular outcomes. Methods In total, 5804 patients were included in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). For the current analysis, 426 were excluded because of overt thyroid disease at baseline or 6 months, 266 because of inconsistent thyroid function at baseline and 6 months, 294 because of medication use that could influence thyroid function, and 16 because of missing kidney or thyroid values. Participants with normal fT4 were classified, based on TSH both at inclusion and 6 months, into three groups: subclinical hypothyroidism (TSH >4.5 mIU/L); euthyroidism (TSH = 0.45–4.5 mIU/L); and subclinical hyperthyroidism (TSH <0.45 mIU/L). Strata of kidney function were made based on estimated glomerular filtration rate into three clinically relevant groups: <45, 45–60, and >60 mL/min/1.73 m2. The primary endpoint consists of death from coronary heart disease, non-fatal myocardial infarction and (non)fatal stroke. Results Mean age was 75.3 years, and 49.0% patients were male. Mean follow-up was 3.2 years. Of all participants, 109 subjects (2.2%) had subclinical hypothyroidism, 4573 (94.0%) had euthyroidism, and 182 (3.7%) subclinical hyperthyroidism. For patients with subclinical hypothyroidism, euthyroidism, and subclinical hyperthyroidism, primary outcome occurred in 9 (8.3%), 712 (15.6%), and 23 (12.6%) patients, respectively. No statistically significant relationship was found between subclinical thyroid dysfunction and primary endpoint with adjusted hazard ratios of 0.51 (0.24–1.07) comparing subclinical hyperthyroidism and 0.90 (0.58–1.39) comparing subclinical hypothyroidism with euthyroidism. Neither was this relationship present in any of the strata of kidney function, nor did kidney function interact with subclinical thyroid dysfunction in the association with primary endpoint (P interaction = 0.602 for subclinical hyperthyroidism and 0.388 for subclinical hypothyroidism). Conclusions In this secondary analysis from PROSPER, we found no evidence that the potential association between thyroid hormones and cardiovascular disease is modified by kidney function in older patients with subclinical thyroid dysfunction.

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Thyrotrophin levels and coronary artery calcification: Cross‐sectional results of the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil)

Abstract: Low and low-normal (1st quintile) TSH levels were associated with CAC>100 Agatston units in a sample with subclinical thyroid disorders and euthyroid subjects.

Cited by 14 publications

References 32 publications

Coffee Consumption and Coronary Artery Calcium Score: Cross‐Sectional Results of ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health)

Coffee Consumption and Coronary Artery Calcium Score: Cross‐Sectional Results of ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health)

Subclinical Hypothyroidism with TSH>7 mIU/l and≤10 mIU/l and Coronary Artery Disease

The kidney, subclinical thyroid disease and cardiovascular outcomes in older patients

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