High Prevalence of Thyroid Gland Dysfunction after Pulmonary Arterial Hypertension Treatment According to Real-World Data

Continuous intravenous epoprostenol or treprostinil therapy is essential for the treatment of severe pulmonary arterial hypertension (PAH). However, it has several side effects, including thyroid gland dysfunction. This study aimed to estimate the prevalence rate of thyroid gland dysfunction.We enrolled 52 patients (9 males, 43 females) who were diagnosed with PAH at Gunma University Hospital. Treatment was selected according to disease severity. The characteristics of patients with thyroid gland dysfunction were also assessed. The mean age was 54 ± 21 years. Before PAH treatment initiation, right heart catheterization showed abnormal results (mean pulmonary arterial pressure: 43.4 ± 17.5 mmHg, cardiac index: 2.45 ± 0.97 L/minute/m², and pulmonary vascular resistance: 10.5 ± 8.0 Wood units). Regarding the initial treatment, 30 patients received oral epoprostenol, and 18 received continuous intravenous treprostinil. The overall prevalence rate of thyroid gland dysfunction was 15.4%, with a significantly higher rate in patients initiated with continuous intravenous epoprostenol therapy than in those receiving only oral agents (2.9% versus 38.9%, P = 0.0007).Patients receiving continuous intravenous epoprostenol therapy had a high prevalence rate of thyroid gland dysfunction. Thus, severe PAH should be treated with an understanding that thyroid gland dysfunction is an important side effect in patients with PAH.