{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:37:22Z","timestamp":1767706642068},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2009,6,24]],"date-time":"2009-06-24T00:00:00Z","timestamp":1245801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2009,9]]},"abstract":"<jats:sec><jats:label \/><jats:p> <jats:bold>WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT<\/jats:bold> <\/jats:p><jats:p>\u2022\u2003Thyroid hormone free T4 is associated with QTc\u2010interval prolongation, which is a risk factor for sudden cardiac death.<\/jats:p><jats:p>\u2022\u2003The association between hyperthyroidism and ventricular arrhythmias or sudden cardiac death has been reported in several case reports.<\/jats:p><jats:p> <jats:bold>WHAT THIS STUDY ADDS<\/jats:bold> <\/jats:p><jats:p>\u2022\u2003We investigated in a prospective population\u2010based cohort study and in a case\u2013control study whether use of antithyroid drugs (as a direct cause or as an indicator of poorly controlled hyperthyroidism) is associated with an increased risk of sudden cardiac death.<\/jats:p><jats:p>\u2022\u2003Use of antithyroid drugs was associated with a threefold increased risk of sudden cardiac death.<\/jats:p><jats:p>\u2022\u2003Although this might be due to antithyroid drug use, it could be more readily explained by underlying hyperthyroidism.<\/jats:p><\/jats:sec><jats:sec><jats:title>AIM<\/jats:title><jats:p>Thyroid free T4 is associated with QTc\u2010interval prolongation, which is a risk factor for sudden cardiac death (SCD). Hyperthyroidism has been associated with SCD in case reports, but there are no population\u2010based studies confirming this. The aim was to investigate whether use of antithyroid drugs (as a direct cause or as an indicator of poorly controlled hyperthyroidism) is associated with an increased risk of SCD.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We studied the occurrence of SCD in a two\u2010step procedure in two different Dutch populations. First, the prospective population\u2010based Rotterdam Study including 7898 participants (\u226555 years old). Second, we used the Integrated Primary Care Information (IPCI) database, which is a longitudinal general practice research database to see whether we could replicate results from the first study. Drug use at the index date was assessed with prescription information from automated pharmacies (Rotterdam Study) or drug prescriptions from general practices (IPCI). We used a Cox proportional hazards model in a cohort analysis, adjusted for age, gender and use of QTc prolonging drugs (Rotterdam Study) and conditional logistic regression analysis in a case\u2013control analysis, matched for age, gender, practice and calendar time and adjusted for arrhythmia and cerebrovascular ischaemia (IPCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In the Rotterdam Study, 375 participants developed SCD during follow\u2010up. Current use of antithyroid drugs was associated with SCD [adjusted hazard ratio 3.9; 95% confidence interval (CI) 1.7, 8.7]. IPCI included 1424 cases with SCD and 14\u2003443 controls. Also in IPCI, current use of antithyroid drugs was associated with SCD (adjusted odds ratio 2.9; 95% CI 1.1, 7.4).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Use of antithyroid drugs was associated with a threefold increased risk of SCD. Although this might be directly caused by antithyroid drug use, it might be more readily explained by underlying poorly controlled hyperthyroidism, since treated patients who developed SCD still had low thyroid\u2010stimulating hormone levels shortly before death.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2125.2009.03474.x","type":"journal-article","created":{"date-parts":[[2009,6,24]],"date-time":"2009-06-24T12:55:38Z","timestamp":1245848138000},"page":"447-454","source":"Crossref","is-referenced-by-count":11,"title":["Population\u2010based studies of antithyroid drugs and sudden cardiac death"],"prefix":"10.1111","volume":"68","author":[{"given":"Charlotte","family":"Van Noord","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam C. J. M.","family":"Sturkenboom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine M. J. 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