Duration of Exposure to Thyrotoxicosis Increases Mortality of Compromised AIT Patients: the Role of Early Thyroidectomy.

The Journal of Clinical Endocrinology and Metabolism
Daniele CappellaniFausto Bogazzi

Abstract

Patients with amiodarone-induced thyrotoxicosis (AIT) and severely reduced left ventricular ejection fraction (LVEF) have a high mortality rate that may be reduced by total thyroidectomy. Whether in this subset of patients thyroidectomy should be performed early during thyrotoxicosis or later after restoration of euthyroidism has not yet been settled. Mortality rates, including peritreatment mortality and 5-year cardiovascular mortality, and predictors of death, evaluated by Cox regression analysis. Retrospective cohort study of 64 consecutive patients with AIT selected for total thyroidectomy from 1997 to 2019. Four groups of patients were identified according to serum thyroid hormone concentrations and LVEF: Group 1 (thyrotoxic, LVEF <40%), Group 2 (thyrotoxic, LVEF ≥40%), Group 3 (euthyroid, LVEF < 40%), Group 4 (euthyroid, LVEF ≥40%). Among patients with low LVEF (Groups 1 and 3), mortality was higher in patients undergoing thyroidectomy after restoration of euthyroidism (Group 3) than in those submitted to surgery when still thyrotoxic (Group 1): peritreatment mortality rates were 40% versus 0%, respectively (P = .048), whereas 5-year cardiovascular mortality rates were 53.3% versus 12.3%, respectively (P = .081). Exposure...Continue Reading

References

Oct 1, 1996·Journal of Endocrinological Investigation·F BogazziE Martino
Aug 1, 1997·Thyroid : Official Journal of the American Thyroid Association·F BogazziE Martino
Apr 4, 2002·Journal of Endocrinological Investigation·F BogazziE Martino
Nov 5, 2002·Anaesthesia and Intensive Care·P H K MakUNKNOWN American Society of Anesthesiologists
Aug 13, 2003·Circulation·Thomas J WangRamachandran S Vasan
Mar 25, 2006·European Journal of Endocrinology·Anthony J O'SullivanTerrance Diamond
Jan 9, 2007·Journal of the American College of Cardiology·Faizel OsmanMichael D Gammage
Jun 19, 2007·Journal of the American College of Cardiology·David ConenStefan Osswald
Mar 13, 2008·European Journal of Anaesthesiology·F J FidelerT H Schroeder
Oct 23, 2008·The Journal of Clinical Endocrinology and Metabolism·Kai-Hang YiuWing-Hing Chow
Nov 28, 2009·Best Practice & Research. Clinical Endocrinology & Metabolism·Silvia A Eskes, Wilmar M Wiersinga
Jun 9, 2010·The Journal of Clinical Endocrinology and Metabolism·Fausto BogazziEnio Martino
Jul 2, 2010·Case Reports in Medicine·Paul CalisLeon Aarts
Jul 5, 2011·European Journal of Endocrinology·Frans BrandtThomas H Brix
Dec 2, 2011·The Journal of Clinical Endocrinology and Metabolism·Silvia A EskesWilmar M Wiersinga
Aug 7, 2012·The Journal of Clinical Endocrinology and Metabolism·Luca TomistiFausto Bogazzi
Sep 8, 2012·European Journal of Endocrinology·Bernadette Biondi
Nov 7, 2012·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Sara SulpizioFederico Selvaggi
Oct 26, 2013·JACC. Heart Failure·Judith E MitchellGust H Bardy
Mar 25, 2014·The Journal of Clinical Endocrinology and Metabolism·Christian SelmerGunnar Hilmar Gislason
Oct 25, 2014·The Journal of Clinical Endocrinology and Metabolism·Trevor E AngellJonathan S LoPresti
Aug 16, 2016·Thyroid : Official Journal of the American Thyroid Association·Douglas S RossMartin A Walter
Apr 4, 2017·The Journal of Clinical Endocrinology and Metabolism·Mads Lillevang-JohansenLaszlo Hegedüs
Apr 21, 2018·Journal of the American College of Cardiology·Salman RazviGiorgio Iervasi
Jan 17, 2019·Thyroid : Official Journal of the American Thyroid Association·Mads Lillevang-JohansenLaszlo Hegedüs
Sep 24, 2019·The Journal of Clinical Endocrinology and Metabolism·Daniele CappellaniFausto Bogazzi
Nov 13, 2019·Critical Care Medicine·Simon BourcierMatthieu Schmidt

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Jul 18, 2021·Thyroid : Official Journal of the American Thyroid Association·Daniele CappellaniFausto Bogazzi

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