Graves’ disease is an autoimmune condition that results in hyperthyroidism and pretibial myxedema. The initial line of treatment includes the use of antithyroid drugs, radioiodine, or surgery, but recent evidence suggests the association of initial therapy with the risk of cardiovascular events. The objective of this study is to investigate the association between primary therapy of Graves’ disease and the risk of CVD morbidity and mortality.

This is a retrospective cohort study that included a total of 4,189 patients (3,414 females and 775 males) with Graves’ disease defined by a positive TSH-receptor antibody (TRAb) test. The patients were grouped into the antithyroid group, radioiodine-resolved group, or the unresolved radioiodine group. A total of 16.756 controls were also included. The risk of CVD disease and morbidity was contrived using Kaplan-Meier and Cox regression models, and the primary outcome was the incidence of a CVD event.

All the patients had higher all-cause mortality than the controls. The risk of CVD events, when compared with the patients in the antithyroid group, was higher in the radioiodine-resolved group than those in the unresolved radioiodine group.

The research concluded that the initial line of therapy in patients with Graves’ disease is associated with improved overall survival, regardless of the method of treatment.