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Program Number: B105
Session Name: Poster Session

Evaluating Treatment Modality on Cure Rates for Cardiovascular Disease in Graves' Patients: A Retrospective Cohort Study Comparing Antithyroid Medication, Total Thyroidectomy, and I-131 Therapy

Christine Robbie, BS, MPH¹; Yaser Y Bashumeel, MD²; Ahmed Shams, Resident¹; Emad Kandil, MD, FACS³; ¹Tulane University School of Medicine; ²Endocrine and Oncology Division, Department of Surgery, Tulane University School of Medicine; ³Department of Surgery, Tulane University School of Medicine

Background: Patients with Graves' disease are at an increased risk for cardiovascular complications. The effect of treatment choice—antithyroid medication, radioiodine therapy, or thyroid surgery—on cardiovascular outcomes and their cure rates are uncertain. This study aimed to assess and compare these factors among Graves' disease patients treated by different modalities.

Methods: This retrospective cohort analysis utilized real-world data from the TriNetX Research network, which is comprised of greater than 155 million patients. Patients ≥18 years of age with Graves' disease and no prior cardiovascular disease were included. The primary outcomes assessed were cardiovascular complications (arrhythmias and hypertension) and cure rates 6 months after treatment.

Results: In a cohort of 1,911 patients with atrial fibrillation (Afib), treatment groups included 1,267 patients (66.3%) on antithyroid medication, 275 (14.4%) undergoing surgery, and 369 (19.3%) receiving I-131. Surgery achieved the highest cure rate at 85.09%, followed by radioiodine therapy at 81.03%, and lastly antithyroid medication at 72.93%. In 18,421 patients with hypertension (HTN), 13,685 (74.3%) received antithyroid medication, 2,119 (11.5%) underwent surgery, and 2,617 (14.2%) received I-131. Cure rates for HTN were highest with surgery (64.79%), followed by antithyroid medication (56.00%) and lastly radioiodine therapy (52.43%).

Conclusion: This study demonstrates that surgical intervention for patients with Afib results in significantly higher cure rates (85.09%) compared to antithyroid medication (72.93%) and radioiodine therapy (81.03%). Similarly, surgery for patients with HTN (64.79%) outperformed both medication (56.00%) and radioiodine therapy (52.43%). Relative risk analyses confirm that surgery enhances improvement likelihood for both conditions. These findings suggest prioritizing surgical options in treatment plans for patients with Afib and HTN. Further research is warranted to evaluate sustained cure rates and the long-term effects of treatment modality.

 

 

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