{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:48Z","timestamp":1792787748694,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Gr\u00f6nbergs Foundation"},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Swedish state under the agreement between the Swedish government and the county councils"},{"name":"Foundation Stiftelsen f\u00f6r Kirurgiskt samarbete"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Surg"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The study aimed to analyze thyroid-stimulating hormone (TSH) levels quantitatively and investigate their potential correlation with the risk of incident atrial fibrillation (AF) in differentiated thyroid cancer (DTC) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>DTC cases diagnosed between 1995 and 2015 in Stockholm, Sweden, were identified from the Swedish Cancer Registry. Medical records were scrutinized, and follow-up began 9\u2009months post-surgery with tracking data until the earliest AF record, censoring, or 31 August 2022. TSH values were classified as unsuppressed (TSH\u2009&gt;\u20090.5 mE\/L), mildly suppressed (TSH 0.1\u20130.5 mE\/L), or suppressed (TSH\u2009&lt;\u20090.1 mE\/L), with graphical analysis spanning up to a 10-year follow-up period. In addition, a nested case\u2013control study assessed the impact of TSH category on incident AF. Additional data on cardiovascular risk factors were gathered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 608 patients, approximately 78% maintained suppressed TSH levels for over half of their follow-up time. Notably, there was a decrease in the proportion of patients receiving long-term TSH suppression after 2013. Among 39 newly diagnosed AF cases, most were in the suppressed TSH category. Moreover, about half of these new AF patients had established cardiovascular risk factors prior to DTC diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>DTC patients generally adhered to TSH suppression guidelines, with a decline observed in the proportion of suppressed TSH values following the adoption of individualized treatment in 2013. The study could not establish a clear link between TSH suppression and the risk of incident AF, highlighting the need for further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14574969251364947","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T01:30:52Z","timestamp":1755048652000},"page":"446-452","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["TSH variability and atrial fibrillation in patients with DTC: A regional cohort study"],"prefix":"10.1177","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1579-0431","authenticated-orcid":false,"given":"Maximilian","family":"Zoltek","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm, 17176 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Therese M.-L.","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"Hedman","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Research and Development Department, Stockholms Sjukhem Foundation, Stockholm, Sweden"},{"name":"Department of Clinical Sciences Lund, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Nordenvall","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Colorectal Surgery Unit, Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina I.","family":"Lundgren","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30172-6"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11275"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19981215)83:12<2638::AID-CNCR31>3.0.CO;2-1"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4266(16)30014-2"},{"issue":"12","key":"e_1_3_2_7_2","first-page":"4318","article-title":"Degree of thyrotropin suppression as a prognostic determinant in differentiated thyroid cancer","volume":"81","author":"Pujol P","year":"1996","unstructured":"Pujol P, Daures JP, Nsakala N, et al: Degree of thyrotropin suppression as a prognostic determinant in differentiated thyroid cancer. J Clin Endocrinol Metab 1996;81(12):4318\u20134323.","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"e_1_3_2_8_2","first-page":"3655","article-title":"Effect of TSH suppression therapy on bone mineral density in differentiated thyroid cancer: A systematic review and meta-analysis","volume":"106","author":"Ku EJ","year":"2021","unstructured":"Ku EJ, Yoo WS, Lee EK, et al: Effect of TSH suppression therapy on bone mineral density in differentiated thyroid cancer: A systematic review and meta-analysis. J Clin Endocrinol Metab 2021;106(12):3655\u20133667.","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0311"},{"key":"e_1_3_2_10_2","first-page":"1519","article-title":"Cardiovascular mortality in 6900 patients with differentiated thyroid cancer: A Swedish population-based study","volume":"2","author":"Maximilian Z","year":"2017","unstructured":"Maximilian Z, Therese A, Christel H, et al: Cardiovascular mortality in 6900 patients with differentiated thyroid cancer: A Swedish population-based study. Clin Surg 2017;2:1519.","journal-title":"Clin Surg"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-019-05249-8"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.49.1043"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-2782"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.3.8302"},{"issue":"12","key":"e_1_3_2_15_2","first-page":"4701","article-title":"Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients","volume":"85","author":"Biondi B","year":"2000","unstructured":"Biondi B, Palmieri EA, Fazio S, et al: Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. J Clin Endocrinol Metab 2000;85(12):4701\u20134705.","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.25011\/cim.v35i3.16591"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0319"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0620"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2006.16.381"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0536"},{"key":"e_1_3_2_21_2","unstructured":"Cancercentrum. Nationellt v\u00e5rdprogram sk\u00f6ldk\u00f6rtelcancer 2021. www.cancercentrum.se"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14787"},{"issue":"12","key":"e_1_3_2_23_2","first-page":"3644","article-title":"Cardiovascular outcomes in thyroid cancer patients treated with thyroidectomy: A meta-analysis","volume":"106","author":"Lee EK","year":"2021","unstructured":"Lee EK, Ahn HY, Ku EJ, et al: Cardiovascular outcomes in thyroid cancer patients treated with thyroidectomy: A meta-analysis. J Clin Endocrinol Metab 2021;106(12):3644\u20133654.","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-20-0496"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.991876"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-18-0551"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13519"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.7754"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2006.16.1229"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2015-1346"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0161"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1998.8.737"},{"key":"e_1_3_2_33_2","unstructured":"Zoltek: Cardiovascular disease and health anxiety in patients with differentiated thyroid cancer 2023. https:\/\/openarchive.ki.se\/articles\/thesis\/Cardiovascular_disease_and_health_anxiety_in_patients_with_differentiated_thyroid_cancer\/26906869"}],"container-title":["Scandinavian Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969251364947","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14574969251364947","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969251364947","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:00:18Z","timestamp":1777698018000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14574969251364947"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/14574969251364947"],"URL":"https:\/\/doi.org\/10.1177\/14574969251364947","relation":{},"ISSN":["1457-4969","1799-7267"],"issn-type":[{"value":"1457-4969","type":"print"},{"value":"1799-7267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]}}}