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,...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-12-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S188042761630031X |
| _version_ | 1811276170751115264 |
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| author | Sayoko Kinoshita Tomohiro Hayashi Kyoichi Wada Mikie Yamato Takeshi Kuwahara Toshihisa Anzai Mai Fujimoto Kouichi Hosomi Mitsutaka Takada |
| author_facet | Sayoko Kinoshita Tomohiro Hayashi Kyoichi Wada Mikie Yamato Takeshi Kuwahara Toshihisa Anzai Mai Fujimoto Kouichi Hosomi Mitsutaka Takada |
| author_sort | Sayoko Kinoshita |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-12T23:52:48Z |
| format | Article |
| id | doaj.art-a76e3ec830474d9b8e224b70e0949ba7 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 |
| language | English |
| last_indexed | 2024-04-12T23:52:48Z |
| publishDate | 2016-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-a76e3ec830474d9b8e224b70e0949ba72022-12-22T03:11:39ZengWileyJournal 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 |
| 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 |
| title | 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_short | Risk factors for amiodarone-induced thyroid dysfunction in Japan |
| title_sort | risk factors for amiodarone induced thyroid dysfunction in japan |
| topic | Amiodarone-induced hyperthyroidism Amiodarone-induced hypothyroidism Subclinical hyperthyroidism Subclinical hypothyroidism |
| url | http://www.sciencedirect.com/science/article/pii/S188042761630031X |
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