Endocrine Abstracts

Background: Parathyroid hormone excess is associated with increased risk of cardiovascular disease (CVD). The aim of the study is to evaluate the correlation between primary hyperparathyroidism (PHPT) and CVD or cardiovascular death (CV death).

Method: Database research was conducted via PubMed and Embase on November 21st, 2022, with key words as following: “cardiovascular disease” “cardiovascular death” and “primary hyperparathyroidism”. A total of 10 cohort studies and 1 randomized controlled trial were included in our analysis. Our primary outcomes were CV death and CVD. Patients with PHPT were compared to general population. We also compare patients that had received parathyroidectomy (PTX) to those without PTX. The variables were pooled as hazard ratios or standard mortality ratios, and a meta-analysis using random-effects model was performed.

Result: A total of 11 studies were identified, including 259,218 PHPT patients with or without PTX, and of which 192,315 were women (74.1%). The average of mean ages reported in 9 studies available was 61.9 years. PHPT was associated with higher risk of CV death when compared to general population (RR 1.61 [95% confidence interval (CI) 1.47-1.78]); however, there was no significant difference of CVD risk between patients with PHPT and general population (RR 1.73 [95% CI 0.87-3.47]. When compared to patients without PTX, PTX had lower risk of CV death (RR 0.75 [95% CI 0.71-0.80]) and CVD (RR 0.92 [95% CI 0.90-0.94]).

Conclusions: Patients with PHPT had higher risk of CV death than general population, and PTX reduced the risk of CV death and CVD.