P375The impact of hypothyroidism on hospitalization frequency and cost-effectiveness among patients with atrial fibrillation

Abstract

Abstract Background thyroid disorders are a well-known fact of high risk developing of atrial fibrillation (AF). While it is established that hyperthyroidism increases AF incidence, data of the effect of hypothyroidism on AF and heart failure is contradictory. Purpose to examine effect of untreated hypothyroidism on frequency of paroxysmal AF, state of the permanent AF and chronic heart failure (CHF) which is the main cause of high rate repeated hospitalizations. Methods This retrospective study was conducted among patients (pts) with AF, who were admitted to the hospital from June 2018 till June 2019. They were divided into 2 groups: 1-st group – pts with AF and hypothyroidism and 2-nd group – euthyroid pts (by using hormonal replacement therapy) with AF. All pts were surveyed about their age, gender, medical history, therapy, number and reasons for hospitalization for the past 12 months. Reference range of TSH was 0,4-4,0 mU/L. Results A total of 75 pts, 57,3% (n = 43) women, 41,3% (n = 31) men, mean age 70,5 years (SD 6,7) were enrolled in the research. 1-st group consist of 66,7% (n = 24) women, 33,3% (n = 12) men, mean age 70,3 years (SD 6,8), paroxysmal AF 38,9% (n = 14), permanent AF 61,1% (n = 22), first diagnosed hypothyroidism during hospitalization 61,1% (n = 22), mean TSH 9,3 mU/L (SD 3,7), 33,3 % (n = 12) were re-admitted 2 and more times, mean hospitalization duration 7,1 day (SD 1,1). 2-nd group consist of 51,3% (n = 20) women, 48,7% (n = 19) men, mean age 70,6 years (SD 10,6), paroxysmal AF 35,9% (n = 14), permanent AF 64,1% (n = 25), mean TSH 2,1 mU/L (SD 1,12), 17,9 % (n = 7) were hospitalized 2 times, mean hospitalization duration 5,9 day (SD 0,9). Reasons for hospitalization in the 1-st group were pharmacological cardioversion (n = 8) and decompensated CHF (n = 4), in the 2-nd group were pharmacological cardioversion (n = 2) and decompensated CHF (n = 5). Average cost of whole hospitalization in the 1-st group was 252$ (SD 8,1), in the 2-st group – 221 $ (SD 5,2). As an example, average cost for patient with CHF and AF per month in Ukraine is 45 $. Conclusion Tight control of thyroid function ensures optimal dose of hormonal replacement therapy and decrease number of repeated hospitalizations and average hospitalization duration in patients with AF and hypothyroidism. As a result, we receive improving of cost-effectiveness of hospitalization AF pts.