Clinical features and risk factors analysis of patients with hyperthyroidism complicating atrial fibrillation
Objective To analyze the clinical characteristics and prognosis differences of the patients with hyperthyroidism complicating atrial fibrillation.Methods A retrospective analysis was adopted.The clinical data of 1 160 patients with hyperthyroidism admitted and treated in the Second Affiliated Hospital of Chengdu Medical College during 2004-2022 were collected.The patients were divided into the atrial fibrilla-tion group(n=581)and non-atrial fibrillation group(n=579)according to whether complicating atrial fibril-lation.Then the levels of thyroid functional indicators[free triiodothyronine(FT3),free tetraiodothyronine(FT4),thyroid-stimulating hormone(TSH)],cholesterol,brain natriuretic peptide(BNP),N-terminal brain natriuretic peptide precursor(NT-proBNP)and triglyceride(TG)as well as the hypertension history,diabetic history,smoking history,inner diameter of left and right atrium(ventricle),ejection fraction and NYHA grade were analyzed and compared between the two groups.The multivariate logistic regression analysis was per-formed for the above possible risk factors.Results There were statistically significant differences in the age,FT3,TSH,left atrial diameter,LVEF,NYHA grade,BNP and NT-proBNP between the two groups(P<0.05).The multivariate logistic regression analysis results showed that left atrial inner diameter rather large,TSH rather low and BNP rather high were the independent risk factors for atrial fibrillation occurrence in the patients with hyperthyroidism.The results of receiver operating characteristic(ROS)curve of above 3 indica-tor in predicting the occurrence of atrial fibrillation occurrence in the patients with hyperthyroidism showed that the area under the curve of left atrial inner diameter was significantly higher than that of TSH and BNP,and the differences were statistically significant(P<0.05).Conclusion When the left atrial inner diameter in the patients with hyperthyroidism is enlarged,TSH is decreased and BNP is increased,the risk of atrial fibril-lation occurrence is increased.