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We investigated associations of thyroid\u2010stimulating hormone (<jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>) with these outcomes in a nationwide population\u2010based prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined 5211 participants representative of the Finnish population aged \u226530\u00a0years in 2000\u20102001 and followed them for a median of 13.2\u00a0years. Using Cox proportional hazards regression models adjusted for baseline age, gender, smoking, diabetes, systolic blood pressure and total and high\u2010density lipoprotein cholesterol, we assessed the associations of continuous baseline <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> categories (low [&lt;0.4\u00a0mU\/L], reference range [0.4\u20103.4\u00a0mU\/L] and high [&gt;3.4\u00a0mU\/L]) with incident total mortality, <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content>, coronary heart disease events, stroke, <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>, major adverse cardiac events and atrial fibrillation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>High <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> at baseline was related to a greater risk of total mortality (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 1.34, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.02\u20101.76) and <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 2.28, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.13\u20104.60) compared with <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> within the reference range. High <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> was not associated with the other outcomes (<jats:italic>P\u00a0<\/jats:italic>\u2265<jats:italic>\u00a0<\/jats:italic>.51), whereas low <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> was not associated with any of the outcomes (<jats:italic>P\u00a0<\/jats:italic>\u2265<jats:italic>\u00a0<\/jats:italic>.09). <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> at baseline over the full range did not have a linear relation with any of the outcomes (<jats:italic>P\u00a0<\/jats:italic>\u2265<jats:italic>\u00a0<\/jats:italic>.17). <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> showed a U\u2010shaped association with total mortality after a restricted cubic spline transformation (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thyroid function abnormalities could be linked with higher risks of total mortality and <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content>. Large\u2010scale randomized studies are needed for evidence\u2010based recommendations regarding treatment of mild thyroid failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13472","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T13:12:39Z","timestamp":1504271559000},"page":"105-113","source":"Crossref","is-referenced-by-count":38,"title":["Thyroid\u2010stimulating hormone and risk of sudden cardiac death, total mortality and cardiovascular morbidity"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2382-7962","authenticated-orcid":false,"given":"Ville L.","family":"Lang\u00e9n","sequence":"first","affiliation":[{"name":"Department of Health National Institute for Health and Welfare Helsinki Finland"},{"name":"Heart Centre Turku University Hospital Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teemu J.","family":"Niiranen","sequence":"additional","affiliation":[{"name":"Department of Health National Institute for Health and Welfare Helsinki Finland"},{"name":"The Framingham Heart Study Framingham MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauli","family":"Puukka","sequence":"additional","affiliation":[{"name":"Department of Health National Institute for Health and Welfare Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arttu O.","family":"Lehtonen","sequence":"additional","affiliation":[{"name":"Department of Health National Institute for Health and Welfare Helsinki Finland"},{"name":"Department of Geriatrics Turku City Hospital and University of Turku Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jussi A.","family":"Hernesniemi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Life Sciences University of Tampere and Heart Centre Tampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jouko","family":"Sundvall","sequence":"additional","affiliation":[{"name":"Department of Health National Institute for Health and Welfare Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veikko","family":"Salomaa","sequence":"additional","affiliation":[{"name":"Department of Health National Institute for Health and Welfare Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti M.","family":"Jula","sequence":"additional","affiliation":[{"name":"Department of Health National Institute for Health and Welfare Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,14]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"World Health Organization. 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