Age Difference in the Association between Hyponatremia and Infection-Related Mortality in Peritoneal Dialysis Patients

2020 ◽  
Vol 49 (5) ◽  
pp. 631-640
Author(s):  
Yagui Qiu ◽  
Hongjian Ye ◽  
Yating Wang ◽  
Zhong Zhong ◽  
Hongyu Li ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Sodium ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Age Difference ◽  
Baseline Serum ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Related Mortality

Objectives: This study aimed to examine the association of serum sodium with infection-related mortality and its age difference among continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: A total of 1,656 CAPD patients from January 2006 to December 2013 were included in this study. All patients were followed up until December 2018. Hyponatremia was defined as serum sodium <135 mmol/L. Cox proportional hazards regression model was used to investigate the relationship between baseline serum sodium levels and infection-related mortality. Results: Participants were aged 47.5 ± 15.3 years, 666 (40.2%) patients were female. Glomerulonephritis was the main cause of end-stage renal disease (61.1%). After a median of 46 months of follow-up, 507 patients died. Among the deaths, 252 (49.7%) died from cardiovascular diseases, 105 (20.7%) from infections, and 150 (29.6%) from other causes. The overall infection-related mortality was 14.8 events per 1,000 patients-year, which was higher in patients aged ≥50 years than those younger than 50 years (28.3 vs. 5.3 events per 1,000 patients-year). In the entire cohort, hyponatremia at was not associated with infection-related (hazards ratios [HR] 1.66, 95% CI 0.91–3.02) and all-cause mortality (HR 1.14, 95% CI 0.83–1.57) after adjusting for potential confounders. There was a significant interaction by age of association of serum sodium with infection-related (p = 0.002) and all-cause (p = 0.0002) death. Age-stratified analysis showed that compared with control group, hyponatremia was independently related to increased risks of infection-related death, but not all-cause mortality in patients aged ≥50 years, with HR of 2.32 (95% CI 1.25–4.32) and 1.33 (95% CI 0.95–1.87), respectively. Conclusions: Hyponatremia was associated with increased risk of infection-related mortality in CAPD patients aged ≥50 years.

Elevated Serum Trimethylamine N-Oxide Levels Are Associated with Mortality in Male Patients on Peritoneal Dialysis

2021 ◽  
pp. 1-11
Author(s):  
Dongying Fu ◽  
Jiani Shen ◽  
Wei Li ◽  
Yating Wang ◽  
Zhong Zhong ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Proportional Hazards ◽  
Elevated Serum ◽  
Ultra Performance Liquid Chromatography ◽  
Cox Proportional Hazards ◽  
Serum Samples ◽  
Entire Cohort ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Male Patients

Background: Elevated levels of serum trimethylamine N-oxide (TMAO) have been previously linked to adverse cardiovascular (CV) and all-cause mortality in hemodialysis patients. However, the clinical significance of serum TMAO levels in patients treated with peritoneal dialysis (PD) is unclear. Methods: A total of 1,032 PD patients with stored serum samples at baseline were enrolled in this prospective study. Serum concentrations of TMAO were quantified by ultra-performance liquid chromatography-tandem mass spectrometry. Cox proportional hazards and competing-risk regression models were performed to examine the association of TMAO levels with all-cause and CV mortality. Results: The median level of serum TMAO in our study population was 34.5 (interquartile range (IQR), 19.8–61.0) μM. During a median follow-up of 63.7 months (IQR, 43.9–87.2), 245 (24%) patients died, with 129 (53%) deaths resulting from CV disease. In the entire cohort, we observed an association between elevated serum TMAO levels and all-cause mortality (adjusted subdistributional hazard ratio [SHR], 1.22; 95% confidence interval [95% CI], 1.01–1.48; p = 0.039) but not CV mortality. Further analysis revealed such association differed by sex; the elevation of serum TMAO levels was independently associated with increased risk of both all-cause (SHR, 1.37; 95% CI, 1.07–1.76; p = 0.013) and CV mortality (SHR, 1.41; 95% CI, 1.02–1.94; p = 0.038) in men but not in women. Conclusions: Higher serum TMAO levels were independently associated with all-cause and CV mortality in male patients treated with PD.

scholarly journals Serum Sodium Modifies the Association of Systolic Blood Pressure with Mortality in Peritoneal Dialysis Patients

2020 ◽  
Vol 45 (6) ◽  
pp. 916-925
Author(s):  
Yagui Qiu ◽  
Hongjian Ye ◽  
Li Fan ◽  
Xunhua Zheng ◽  
Wei Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Serum Sodium ◽  
Subgroup Analysis ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Dialysis Patients ◽  
Baseline Serum ◽  
All Cause Mortality ◽  
Cv Disease

<b><i>Introduction:</i></b> High serum sodium is associated with increased blood pressure (BP) in dialysis patients, which is a risk factor for cardiovascular (CV) disease. However, the interaction between serum sodium and BP and their association with clinical outcomes in peritoneal dialysis (PD) patients is uncertain. <b><i>Methods:</i></b> We analyzed a retrospective cohort of 1,656 incident PD patients from January 2006 to December 2013, who were followed up until December 2018. Cox proportional hazards regression models were used to evaluate the association of serum sodium and BP with all-cause and CV mortality. A priori interaction between serum sodium and systolic BP (SBP) was explored, and a subgroup analysis was performed by stratifying SBP into the following 3 groups: &#x3c;110, 110–130, and &#x3e;130 mm Hg. <b><i>Results:</i></b> Mean baseline serum sodium was 140.2 ± 3.6 mmol/L, mean SBP was 137 ± 20 mm Hg, and diastolic BP was 85 ± 14 mm Hg. During a median (range) follow-up time of 46.5 (2.6–154.3) months, 507 patients died, 252 of whom died due to CV disease. SBP did not predict all-cause and CV mortality when BP was assessed as a continuous variable. However, SBP &#x3e;130 or &#x3c;110 mm Hg was associated with higher risk of all-cause and CV mortality compared with SBP of 110–130 mm Hg. There was a significant interaction between baseline serum sodium and SBP for all-cause mortality (<i>p</i> for interaction = 0.016). In subgroup analysis, among those with SBP &#x3e;130 mm Hg, the risk of all-cause mortality was elevated in those with serum sodium ≥140 mmol/L (adjusted hazard ratio [aHR] 1.45 [95% confidence interval (CI): 1.07–1.98]), but not for those with serum sodium &#x3c;140 mmol/L (aHR 1.27 [95% CI: 0.89–1.82]). Conversely, among those with SBP &#x3c;110 mm Hg, those with serum sodium &#x3c;140 mmol/L had an elevated risk of mortality (aHR 1.99 [95% CI: 1.31–3.02]), but not those with serum sodium ≥140 mmol/L (aHR 1.15 [95% CI: 0.74–1.79]) (<i>p</i> for interaction = 0.028). <b><i>Conclusion:</i></b> The association of BP with mortality was modified by serum sodium levels in PD patients. Further studies are needed to evaluate whether individualized BP control based on serum sodium levels contributes to improve patient outcomes.

Faster Transport Status and Mortality in Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

2015 ◽  
Vol 40 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Liping Xiong ◽  
Li Fan ◽  
Qingdong Xu ◽  
Qian Zhou ◽  
Huiyan Li ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
All Cause Mortality ◽  
History Of ◽  
The Relationship

Background: There are limited data regarding the relationship between transport status and mortality in anuric continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: According to the dialysate to plasma creatinine ratio (D/P Cr), 292 anuric CAPD patients were stratified to faster (D/P Cr ≥0.65) and slower transport groups (D/P Cr <0.65). The Cox proportional hazards models were used to evaluate the association of transport status with mortality. Results: During a median follow-up of 22.1 months, 24% patients died, 61.4% of them due to cardiovascular disease (CVD). Anuric patients with faster transport were associated with an increased risk of all-cause mortality (HR (95% CI) = 2.16 (1.09-4.26)), but not cardiovascular mortality, after adjustment for confounders. Faster transporters with pre-existing CVD had a greater risk for death compared to those without any history of CVD. Conclusion: Faster transporters were independently associated with high all-cause mortality in anuric CAPD patients. This association was strengthened in patients with pre-existing CVD.

scholarly journals Co-Existence of Diabetes Mellitus And Pre-Existing Cardiovascular Disease, Diabetes Mellitus, And Pre-Existing Cardiovascular Disease And Mortality in Peritoneal Dialysis Patients

2020 ◽  
Author(s):  
Xiaojiang Zhan ◽  
Yueqiang Wen ◽  
Qian Zhou ◽  
Xiaoran Feng ◽  
FenFen Peng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Proportional Hazards ◽  
Multinomial Logistic Regression ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
All Cause Mortality ◽  
Study Population ◽  
Cvd Mortality

Abstract Background: Little is known over the effect of co-existence of diabetes mellitus (DM) and pre-existing cardiovascular disease (CVD), DM, and pre-existing CVD on mortality among continuous ambulatory peritoneal dialysis (CAPD) patients.Methods: A retrospective study, with 2939 incident Chinese CAPD patients from five facilities between January 1, 2005 and December 31, 2018, was conducted. The primary and secondary outcomes were all-cause and CVD mortality. The association between these interesting comorbidities and mortality was evaluated using the Cox proportional hazards regression.Results: Over a median of 35.1 months of follow-up, 519 (17.7%) patients died, with 258 (8.8%) CVD mortality. Hypertension was independently associated with co-existence of DM and pre-existing CVD using multinomial logistic regression (odd ratio 13.72, 95% CI 6.14 to 30.63). After adjusting for confounding factors, DM plus CVD, DM, and pre-existing CVD groups had a higher risk of all-cause mortality (HR 2.85, 95% CI 2.18 to 3.72; HR 1.89, 95% CI 1.50 to 2.38; and HR 1.43, 95% CI 1.07 to 1.92) and CVD mortality (HR 2.79, 95% CI 1.91 to 4.08; HR 1.88, 95% CI 1.35 to 2.61; and HR 1.82, 95% CI 1.23 to 2.68), respectively, compared to the control group. Compared with those pre-existing CVD patients, DM patients had 1.44 (95%CI 1.04 to 1.98)-time and 1.11 (95%CI 0.72 to 1.71) risk of all-cause and CVD mortality, respectively. There was no significant interaction between DM and CVD on all-cause and CVD mortality (β=0.203, P=0.292; β=0.281, P=0.123) in the study population. Conclusions: CAPD patients with co-existence of DM and pre-existing CVD at baseline are at highest risk of all-cause and CVD mortality, followed sequentially by DM patients and pre-existing CVD patients, with hypertension as a powerful predictor for co-existence of DM and pre-existing CVD. DM patients have a higher risk of all-cause mortality and similar risk of CVD mortality compared with pre-existing CVD patients.

Abstract 282: Impact of a Multi-Disciplinary Heart Failure Post-Discharge Management Clinic on Heart Failure Readmission Rates

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Cynthia Jackevicius ◽  
Noelle de Leon ◽  
Lingyun Lu ◽  
Donald Chang ◽  
Alberta Warner ◽  
...  
Keyword(s):  
Heart Failure ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Control Group ◽  
Post Discharge ◽  
Readmission Rates ◽  
All Cause Mortality ◽  
Clinic Group

Background: Specialized heart failure (HF) clinics have demonstrated significant reduction in readmission rates. We evaluated a new multi-disciplinary HF clinic focused specifically on those recently discharged from a HF hospitalization. Methods: In this retrospective, cohort study, patients discharged with a primary HF diagnosis who attended the HF post-discharge clinic in 2010-11 were compared with historical controls from 2009. Within an average of six clinic visits, patients were seen by a physician assistant, a clinical pharmacist and a nurse case manager, with care overseen by an attending cardiologist. The clinic focused on identification of HF etiology and precipitating factors, medication titration to target doses, patient education, and medication adherence. The primary outcome was 90-day HF readmission, with secondary outcomes of mortality and a composite of 90-day HF readmission and mortality. A Cox proportional hazards model with adjustment for potentially confounding demographic and comorbidity variables was constructed to compare outcomes between groups. Results: Among the 277 patients (144 clinic and 133 control) in the study, 7.6% of patients in the clinic group and 23.3% of patients in the control group were readmitted for HF within 90 days (aHR 0.26; 95%CI=0.13-0.53 p = 0.0003;aRRR=74%; 95%CI= 47%-87%; ARR=15.7%;NNT=7). There were few deaths, but adjusted all-cause mortality was lower in the clinic group. For the composite of 90-day HF readmission and mortality, clinic patients had a lower risk (9.0% vs 28.6%; aHR 0.23; 95%CI=0.12-0.45; p<0.0001; aRRR=77%; 95%CI=55%-88%;ARR=19.6%;NNT=6). Conclusion: The multidisciplinary HF post-discharge clinic was associated with a significant reduction in 90-day HF readmission rates and all-cause mortality.

Serum cholinesterase levels to predict all-cause mortality in a community-based study: The Takahata study

2021 ◽  
Author(s):  
Makoto Saegusa ◽  
Yumi Matsuda ◽  
Tsuneo Konta ◽  
Takafumi Saitoh ◽  
Kaori Sakurada ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Independent Predictor ◽  
Correlation Coefficients ◽  
Cox Proportional Hazards ◽  
Serum Cholinesterase ◽  
Community Based ◽  
Baseline Serum ◽  
Middle Group ◽  
Kaplan Meier ◽  
All Cause Mortality

Introduction: Serum albumin (Alb) levels have been found to be independent predictors of all-cause mortality in a community-based population, but whether this is the case for serum cholinesterase (ChE) levels is uncertain. This study aimed to determine whether serum ChE levels are independent predictors of all-cause mortality in a community-based population. Methods: A total of 3,504 subjects (mean age 62.5 years) from Takahata, Japan participated and were followed up for 13.5 years (median 13.2 years). Based on baseline serum Alb and ChE levels, subjects were stratified by interquartile range as low, middle, and high. The correlation between serum Alb and ChE levels was examined by calculating correlation coefficients. The association between each group and all-cause mortality was examined by Kaplan-Meier and Cox proportional hazards analysis. Results: During follow-up, 568 subjects died. There was a positive correlation between serum Alb and ChE levels (r=0.30). Kaplan-Meier analysis showed that all-cause mortality in the low group was significantly higher for both serum Alb and ChE levels (log-rank P<0.01). Adjusted Cox proportional hazards analysis showed that the serum Alb level was not an independent predictor of all-cause mortality (hazard ratio (HR) 1.18, 95% confidence interval (CI) 0.95-1.46 for all-cause mortality in the low group compared to the middle group), whereas the serum ChE level was an independent predictor of all-cause mortality (HR 1.30, 95% CI 1.06-1.59 for all-cause mortality in the low group compared to the middle group). Conclusion: The serum ChE level is an independent predictor of all-cause mortality in the general community-based population.

Association of pulse pressure with all-cause mortality in young adults

2019 ◽  
Vol 96 (1138) ◽  
pp. 461-466
Author(s):  
Jie LI ◽  
Jia-Yi Huang ◽  
Kenneth Lo ◽  
Bin Zhang ◽  
Yu-Qing Huang ◽  
...  
Keyword(s):  
Young Adults ◽  
Pulse Pressure ◽  
Subgroup Analysis ◽  
Proportional Hazards ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Cox Analysis

BackgroundPulse blood pressure was significantly associated with all-cause mortality in middle-aged and elderly populations, but less evidence was known in young adults.ObjectiveTo assess the association of pulse pressure (PP) with all-cause mortality in young adults.MethodsThis cohort from the 1999–2006 National Health and Nutrition Examination Survey included adults aged 18–40 years. All included participants were followed up until the date of death or 31 December 2015. PP was categorised into three groups: <50, 50~60, ≥60 mm Hg. Cox proportional hazards models and subgroup analysis were performed to estimate the adjusted HRs and 95% CIs for all-cause mortality.ResultsAfter applying the exclusion criteria, 8356 participants (median age 26.63±7.01 years, 4598 women (55.03%)) were included, of which 265 (3.17%) have died during a median follow-up duration of 152.96±30.45 months. When treating PP as a continuous variable, multivariate Cox analysis showed that PP was an independent risk factor for all-cause mortality (HR 1.94, 95% CI 1.02 to 3.69; p=0.0422). When using PP<50 mm Hg as referent, from the 50~60 mm Hg to the ≥60 mm Hg group, the risks of all-cause mortality for participants with PP ranging 50–60 mm Hg or ≥60 mm Hg were 0.93 (95% CI 0.42 to 2.04) and 1.15 (95% CI 0.32 to 4.07) (P for tend was 0.959). Subgroup analysis showed that PP (HR 2.00, 95% CI 1.05 to 3.82; p=0.0360) was associated with all-cause mortality among non-hypertensive participants.ConclusionAmong young adults, higher PP was significantly associated with an increased risk of all-cause mortality, particularly among those without hypertension.

scholarly journals Increased Plasma Concentrations of Soluble ST2 are Predictive for 1-Year Mortality in Patients with Acute Destabilized Heart Failure

2008 ◽  
Vol 54 (4) ◽  
pp. 752-756 ◽  
Author(s):  
Thomas Mueller ◽  
Benjamin Dieplinger ◽  
Alfons Gegenhuber ◽  
Werner Poelz ◽  
Richard Pacher ◽  
...  
Keyword(s):  
Heart Failure ◽  
Plasma Concentration ◽  
Proportional Hazards ◽  
Interleukin 1 ◽  
Tertiary Care ◽  
Plasma Concentrations ◽  
Cox Proportional Hazards ◽  
Care Hospital ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background: The soluble isoform of the interleukin-1 receptor family member ST2 (sST2) has been implicated in heart failure. The aim of the present study was to evaluate the capability of sST2 as a prognostic marker in patients with acute destabilized heart failure. Methods: sST2 plasma concentrations were obtained in 137 patients with acute destabilized heart failure attending the emergency department of a tertiary care hospital. The endpoint was defined as all-cause mortality, and the study participants were followed up for 365 days. Results: Of the 137 patients enrolled, 41 died and 96 survived during follow-up. At baseline the median sST2 plasma concentration was significantly higher in the patients who died than in those who survived (870 vs 342 ng/L, P &lt;0.001). Kaplan-Meier curve analyses demonstrated that the risk ratios for mortality were 2.45 (95% CI, 0.88–6.31; P = 0.086) and 6.63 (95% CI, 2.55–10.89; P &lt;0.001) in the second tercile (sST2, 300–700 ng/L; 11 deaths vs 34 survivors) and third tercile (sST2, &gt;700 ng/L; 25 deaths vs 21 survivors) of sST2 plasma concentrations compared with the first tercile (sST2, ≤300 ng/L; 5 deaths vs 41 survivors). In multivariable Cox proportional-hazards regression analyses, an sST2 plasma concentration in the upper tercile was a strong and independent predictor of all-cause mortality. Conclusions: Increased sST2 concentrations determined in plasma samples drawn from patients with acute destabilized heart failure at their initial presentation indicate increased risk of future mortality. Increased sST2 plasma concentrations are independently and strongly associated with one-year all-cause mortality in these patients.

scholarly journals Determining the Joint Effect of Obesity and Diabetes on All-Cause Mortality and Cardiovascular-Related Mortality following an Ischemic Stroke

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Colleen Bauza ◽  
Renee’ Martin ◽  
Sharon D. Yeatts ◽  
Keith Borg ◽  
Gayenell Magwood ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Proportional Hazards ◽  
Joint Effect ◽  
Normal Weight ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Obesity And Diabetes ◽  
All Cause Mortality ◽  
Obese Subjects ◽  
Related Mortality

Although obesity and diabetes mellitus, or diabetes, are independently associated with mortality-related events (e.g., all-cause mortality and cardiovascular-related mortality) following an ischemic stroke, little is known about the joint effect of obesity and diabetes on mortality-related events following an ischemic stroke. The aim of this study is to evaluate the joint effect of obesity and diabetes on mortality-related events in subjects with a recent ischemic stroke. Data from the multicenter Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial was analyzed for this study. The joint effect of obesity and diabetes on mortality-related events was estimated via Cox proportional hazards regression models. No difference in the hazard of all-cause mortality following an ischemic stroke was observed between obese subjects with diabetes and underweight/normal-weight subjects without diabetes. In contrast, obese subjects with diabetes had an increased hazard of cardiovascular-related mortality following an ischemic stroke compared with underweight/normal-weight subjects without diabetes. Additionally, there was evidence of an attributable proportion due to interaction as well as evidence of a highly statistically significant interaction on the multiplicative scale for cardiovascular-related mortality. In this clinical trial cohort of ischemic stroke survivors, obesity and diabetes synergistically interacted to increase the hazard of cardiovascular-related mortality.

scholarly journals Long-term cardiovascular and cerebrovascular morbidity in Israeli thyroid cancer survivors

2019 ◽  
Vol 8 (4) ◽  
pp. 398-406 ◽  
Author(s):  
Elena Izkhakov ◽  
Joseph Meyerovitch ◽  
Micha Barchana ◽  
Yacov Shacham ◽  
Naftali Stern ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Disease ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Study Group ◽  
American Thyroid Association ◽  
Cox Proportional Hazards Models ◽  
Increased Risk

Objective Thyroid cancer (TC) survivors may be at risk of subsequent cardiovascular and cerebrovascular (CaV&CeV) morbidity. The 2009 American Thyroid Association (ATA) guidelines recommended less aggressive treatment for low-risk TC patients. The aim of this study was to assess the atherosclerotic CaV&CeV outcome of Israeli TC survivors compared to individuals with no thyroid disease, and the atherosclerotic CaV&CeV outcome before (2000–2008) and after (2009–2011) implementation of the 2009 ATA guidelines. Methods All members of the largest Israeli healthcare organization who were diagnosed with TC from 1/2000 to 12/2014 (study group) and age- and sex-matched members with no thyroid disease (controls) were included. Adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards models. Results The mean follow-up was 7.6 ± 4.2 and 7.8 ± 4.1 years for the study (n = 5,677, 79% women) and control (n = 23,962) groups, respectively. The former had an increased risk of new atherosclerotic CaV&CeV events (adjusted HR 1.26, 95% CI 1.15–1.39). The 5-year incidence of CaV&CeV was lower (adjusted HR 0.49, 95% CI 0.38–0.62) from 2009 to 2011 compared to 2000 to 2008, but remained higher in the study group than in the control group (adjusted HR 1.5, 95% CI 1.14–1.69). Conclusions This large Israeli population-based cohort study showed greater atherosclerotic CaV&CeV morbidity in TC survivors compared to individuals with no thyroid diseases. There was a trend toward a decreased 5-year incidence of atherosclerotic CaV&CeV events among TC survivors following the implementation of the 2009 ATA guidelines, but it remained higher compared to the general population.

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