Endocrine Abstracts

Introduction: In hyperthyroid patients mortality is increased by 20%, the major causes of death being cardiovascular disorders. Recent data suggest that subclinical or treated thyroid disease is associated with increased long-term vascular risk despite restoration of euthyroidism.

Methods: We measured high-sensitivity C reactive protein (hs-CRP) in 116 newly diagnosed Graves’ disease (GD) patients, without prior antithyroid treatment. Levels of hs-CRP <1 mg/l are associated with a low cardiovascular risk, between 1–3 mg/l with medium risk and >3 mg/l with high risk. We calculated Framingham risk score in 97 patients, using as risk factors: the presence of arterial hypertension, total cholesterol, HDL-cholesterol, age, sex and smoking status. Individuals with low risk have ≤10% CHD risk at 10 years, with intermediate risk 10–20%, and with high risk ≥20%. Patients < 20 years old, with diabetes mellitus, known cardiac diseases or symptoms were excluded.

Results: The mean value of serum hs-CRP was 4.13±7.71 mg/l, mediane=1.80, IQR=4.59 mg/l. Serum hs-CRP mediane level of 1.80 mg/l is asociated with a medium cardiovascular risk. Framingham risk score had a mean value of 2.84±3.58% S.D. and a mediane of 1, interval=1–16, IQR=2%. Framingham score placed the majority of patients (91.8%) in a low cardiovascular risk category and only 8.2% in an intermediate risk category, with no patients in the high risk category. Framingham risk score was higher in men compared to women (mediane=4.50, IQR=11 vs mediane=1, IQR=2%, P<0.001). Intermediate risk patients were older than patients in the low risk group (64.13±10.30 vs 43.89±13.68 years, P<0.001).

Conclusions: Serum hs-CRP values placed GD patients in a medium cardiovascular risk while Framingham risk score placed the majority of patients in low risk group, <10% within the next 10 years. Considering the increased morbidity and mortality associated with hyperthyroidism the development of a specific cardiovascular risk score for this specific category of patients could be useful.