Better adherence to antithyroid drug is associated with decreased risk of stroke in hyperthyroidism patients
Journal
International Journal of Clinical Practice
Journal Volume
69
Journal Issue
12
Pages
1473-1485
Date Issued
2015
Author(s)
Chuang P.-Y.
Chen N.-C.
Yu P.-H.
Cheng H.-J.
Tang C.-H.
Abstract
Background An increased risk for ischaemic stroke has been reported in young hyperthyroidism patients independent of atrial fibrillation (AF). However, whether the use of antithyroid drugs in hyperthyroidism patients can reduce the occurrence of ischaemic stroke remains unclear. Methods A total of 36,510 newly diagnosed hyperthyroidism patients during 2003-2006 were identified from the Taiwan National Health Insurance Research database. Each patient was individually tracked for 5 years from their index date (beginning the antithyroid drugs) to identify those who suffered from new episode of ischaemic stroke. Medication possession ratio (MPR) was used to represent the antithyroid drug compliance. The association between the MPR and the risk of stroke was examined. Results The stroke incidence rates for hyperthyroidism patients with age < 45 years and age ? 45 years were 0.42 and 3.76 per 1000 person-years, respectively. The patients aged < 45 years with MPR < 0.2 (adjusted hazard ratio, HR, 2.30; 95% CI, 1.13-4.70; p = 0.02) and 0.2 ? MPR < 0.4 (adjusted HR, 2.24; 95% CI, 1.06-4.72; p = 0.035) had a significantly increased risk of ischaemic stroke as compared to those with ? 0.6. In patients of the age ? 45 years, only the patients with MPR < 0.2 (adjusted HR, 1.44; 95% CI, 1.03-2.01; p = 0.036) had a significantly higher risk of ischaemic stroke as compared to those with MPR ? 0.6. In hyperthyroidism patients without AF, good antithyroid drugs compliance also reduced the incidence of stroke significantly (adjusted HR, range: 1.52-1.61; p = 0.02); but not in hyperthyroidism with AF. Conclusion Hyperthyroidism patients with good antithyroid drug compliance had a lower risk of ischaemic stroke than patients with poor compliance. ? 2015 John Wiley & Sons Ltd.
SDGs
Other Subjects
antithyroid agent; antithyroid agent; adult; age distribution; aged; Article; brain ischemia; controlled study; disease free survival; female; high risk patient; human; hyperthyroidism; incidence; major clinical study; male; medication compliance; middle aged; patient compliance; priority journal; risk assessment; risk reduction; treatment duration; complication; hyperthyroidism; proportional hazards model; risk factor; Stroke; Taiwan; young adult; Adult; Aged; Antithyroid Agents; Female; Humans; Hyperthyroidism; Incidence; Male; Medication Adherence; Middle Aged; Proportional Hazards Models; Risk Factors; Stroke; Taiwan; Young Adult
Type
journal article