Risk factors for amiodarone-induced thyroid dysfunction in Japan
Background: Amiodarone is associated with a number of significant adverse effects, including elevated transaminase levels, pulmonary fibrosis, arrhythmia, and thyroid dysfunction. Although thyroid dysfunction is considered to be a common and potentially serious adverse effect of amiodarone therapy,...
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doaj-a76e3ec830474d9b8e224b70e0949ba72020-11-24T23:57:51ZengWileyJournal of Arrhythmia1880-42762016-12-0132647448010.1016/j.joa.2016.03.008Risk factors for amiodarone-induced thyroid dysfunction in JapanSayoko Kinoshita0Tomohiro Hayashi1Kyoichi Wada2Mikie Yamato3Takeshi Kuwahara4Toshihisa Anzai5Mai Fujimoto6Kouichi Hosomi7Mitsutaka Takada8Department of Pharmacy, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka 565-8565, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka 565-8565, JapanDepartment of Pharmacy, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka 565-8565, JapanDepartment of Pharmacy, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka 565-8565, JapanDepartment of Pharmacy, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka 565-8565, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka 565-8565, JapanDivision of Clinical Drug Informatics, School of Pharmacy, Kinki University, 3-4-1, Kowakae, Higashiosaka, Osaka 577-0818, JapanDivision of Clinical Drug Informatics, School of Pharmacy, Kinki University, 3-4-1, Kowakae, Higashiosaka, Osaka 577-0818, JapanDivision of Clinical Drug Informatics, School of Pharmacy, Kinki University, 3-4-1, Kowakae, Higashiosaka, Osaka 577-0818, JapanBackground: Amiodarone is associated with a number of significant adverse effects, including elevated transaminase levels, pulmonary fibrosis, arrhythmia, and thyroid dysfunction. Although thyroid dysfunction is considered to be a common and potentially serious adverse effect of amiodarone therapy, the exact pathogenesis remains unknown because of its complex manifestations. Therefore, the prevalence of, and risk factors for, amiodarone-induced thyroid dysfunction in Japanese patients were investigated in the present study. Methods: A retrospective analysis of patients treated with amiodarone between January 2012 and December 2013 was performed. A total of 317 patients with euthyroidism, or subclinical hyperthyroidism or hypothyroidism, were enrolled in this study. Results: After being treated with amiodarone, 30 (9.5%) and 60 patients (18.9%) developed amiodarone-induced hyperthyroidism and amiodarone-induced hypothyroidism, respectively. Ten (33.3%) patients with amiodarone-induced hyperthyroidism and 40 (66.6%) with amiodarone-induced hypothyroidism were diagnosed within two years of the initiation of amiodarone therapy. Dilated cardiomyopathy (DCM) [Adjusted odds ratio (OR) 3.30 (95% confidence interval (CI): 1.26–8.90)], and cardiac sarcoidosis [Adjusted OR 6.47 (95% CI: 1.60–25.77)] were identified as predictors of amiodarone-induced hyperthyroidism. The baseline free thyroxine (T4) level [Adjusted OR 0.13 (95% CI: 0.03–0.68)], and thyroid-stimulating hormone (TSH) level [Adjusted OR1.47 (95% CI: 1.26–1.74)] were identified as predictors of amiodarone-induced hypothyroidism. Conclusion: DCM and cardiac sarcoidosis were identified as risk factors for amiodarone-induced hyperthyroidism. Risk factors for amiodarone-induced hypothyroidism included higher baseline TSH level and lower baseline free T4 level, suggesting that subclinical hypothyroidism may be a potential risk factor for the development of amiodarone-induced hypothyroidism.http://www.sciencedirect.com/science/article/pii/S188042761630031XAmiodarone-induced hyperthyroidismAmiodarone-induced hypothyroidismSubclinical hyperthyroidismSubclinical hypothyroidism |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sayoko Kinoshita Tomohiro Hayashi Kyoichi Wada Mikie Yamato Takeshi Kuwahara Toshihisa Anzai Mai Fujimoto Kouichi Hosomi Mitsutaka Takada |
spellingShingle |
Sayoko Kinoshita Tomohiro Hayashi Kyoichi Wada Mikie Yamato Takeshi Kuwahara Toshihisa Anzai Mai Fujimoto Kouichi Hosomi Mitsutaka Takada Risk factors for amiodarone-induced thyroid dysfunction in Japan Journal of Arrhythmia Amiodarone-induced hyperthyroidism Amiodarone-induced hypothyroidism Subclinical hyperthyroidism Subclinical hypothyroidism |
author_facet |
Sayoko Kinoshita Tomohiro Hayashi Kyoichi Wada Mikie Yamato Takeshi Kuwahara Toshihisa Anzai Mai Fujimoto Kouichi Hosomi Mitsutaka Takada |
author_sort |
Sayoko Kinoshita |
title |
Risk factors for amiodarone-induced thyroid dysfunction in Japan |
title_short |
Risk factors for amiodarone-induced thyroid dysfunction in Japan |
title_full |
Risk factors for amiodarone-induced thyroid dysfunction in Japan |
title_fullStr |
Risk factors for amiodarone-induced thyroid dysfunction in Japan |
title_full_unstemmed |
Risk factors for amiodarone-induced thyroid dysfunction in Japan |
title_sort |
risk factors for amiodarone-induced thyroid dysfunction in japan |
publisher |
Wiley |
series |
Journal of Arrhythmia |
issn |
1880-4276 |
publishDate |
2016-12-01 |
description |
Background: Amiodarone is associated with a number of significant adverse effects, including elevated transaminase levels, pulmonary fibrosis, arrhythmia, and thyroid dysfunction. Although thyroid dysfunction is considered to be a common and potentially serious adverse effect of amiodarone therapy, the exact pathogenesis remains unknown because of its complex manifestations. Therefore, the prevalence of, and risk factors for, amiodarone-induced thyroid dysfunction in Japanese patients were investigated in the present study.
Methods: A retrospective analysis of patients treated with amiodarone between January 2012 and December 2013 was performed. A total of 317 patients with euthyroidism, or subclinical hyperthyroidism or hypothyroidism, were enrolled in this study.
Results: After being treated with amiodarone, 30 (9.5%) and 60 patients (18.9%) developed amiodarone-induced hyperthyroidism and amiodarone-induced hypothyroidism, respectively. Ten (33.3%) patients with amiodarone-induced hyperthyroidism and 40 (66.6%) with amiodarone-induced hypothyroidism were diagnosed within two years of the initiation of amiodarone therapy. Dilated cardiomyopathy (DCM) [Adjusted odds ratio (OR) 3.30 (95% confidence interval (CI): 1.26–8.90)], and cardiac sarcoidosis [Adjusted OR 6.47 (95% CI: 1.60–25.77)] were identified as predictors of amiodarone-induced hyperthyroidism. The baseline free thyroxine (T4) level [Adjusted OR 0.13 (95% CI: 0.03–0.68)], and thyroid-stimulating hormone (TSH) level [Adjusted OR1.47 (95% CI: 1.26–1.74)] were identified as predictors of amiodarone-induced hypothyroidism.
Conclusion: DCM and cardiac sarcoidosis were identified as risk factors for amiodarone-induced hyperthyroidism. Risk factors for amiodarone-induced hypothyroidism included higher baseline TSH level and lower baseline free T4 level, suggesting that subclinical hypothyroidism may be a potential risk factor for the development of amiodarone-induced hypothyroidism. |
topic |
Amiodarone-induced hyperthyroidism Amiodarone-induced hypothyroidism Subclinical hyperthyroidism Subclinical hypothyroidism |
url |
http://www.sciencedirect.com/science/article/pii/S188042761630031X |
work_keys_str_mv |
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