Meta-Analysis Details CVD Risk After Thyroidectomy in Patients with Thyroid Cancer

Patrick Campbell

Data from AACE 2021 suggests the risk of cardiovascular disease was 15% greater among patients with thyroid cancer who underwent thyroidectomy than the general population, but found no significant difference in risk of cardiac mortality and atrial fibrillation.

This article was originally published on EndocrinologyNetwork.com.

A systematic review and meta-analysis presented at AACE 2021 provide a comprehensive overview of the risk of cardiovascular disease in patients with thyroid cancer from current literature.

Using data from nearly 200,000 patients with thyroid cancer receiving thyroidectomy, investigators were able to shed light on the incidence of cardiovascular disease, atrial fibrillation (AF), and cardiovascular mortality among patients with thyroid cancer as a whole and based on whether or not they received treatment with radioactive iodine.

“To our knowledge, this study is the first meta-analysis to examine the association of thyroid cancer with cardiovascular disease. These results provide insights toward optimizing thyroid cancer strategies that should consider the potential harms and benefits during cancer treatment,” wrote study investigators.

Presented by Wen Hsuan Tsai, MD, the study was designed as a systematic review and meta-analysis with the intent of detailing the association between thyroid cancer and cardiovascular disease from literature available in the PubMed, Embase, and Cochrane Library databases from inception through November 25, 2020. For the purpose of analysis, investigators limited their review to prospective and retrospective studies and keywords used in their search of the aforementioned databases included thyroid cancer, AF, cardiovascular disease, and thyroxine.

The primary outcomes of interest for the analyses were incidence of cardiovascular disease, AF, and cardiovascular mortality among thyroid cancer compared to the general population and secondary outcomes included incidence of these outcomes among patients with and without radioactive iodine treatment.

In total, 9 studies met inclusion criteria. From these 9 studies, investigators obtained data related to 197,202 patients with thyroid cancer receiving thyroidectomy.

In a pair of studies, risk estimates indicated patients with thyroid cancer were at a 15% greater risk of cardiovascular disease than the general population (RR, 1.15; 95% CI, 1.10-1.21). In an analysis of 3 studies measuring incidence of AF, results suggested a significant difference in a fixed-effect model (RR, 1.37; 985% CI, 1.15-1.62) but no significant difference in the random effect model (RR, 1.47; 95% CI, 0.96-2.23) when compared to the general population.

When assessing cardiovascular mortality in a group of 3 studies, results indicated the association between cardiovascular mortality and thyroid cancer was insignificant (RR, 0.82; 95% CI, 0.66-1.01). Additionally, analysis of pooled data from 3 studies indicated there was no significant difference in risk of cardiovascular disease among patients based on whether they received RAI treatment after thyroidectomy (RR, 1.01; 95% CI, 0.81-1.26).

This study, “Association of thyroid cancer with cardiovascular disease, atrial fibrillation and cardiovascular-specific mortality: A systematic review and meta-analysis,” was presented at AACE 2021.