Incidence of thyroid dysfunction following initiation of amiodarone treatment in patients with and without heart failure: a nationwide cohort study

Autor: S A A Ali, M E Ersboll, N J V Vinding, J H B Butt, R R Rorth, C S Selmer, L M W Westergaard, U M M Mogensen, P E W Weeke, C J Jons, F G Gustafsson, E F Fosbol, L K Kober, S L K Kristensen
Rok vydání: 2022
Předmět:
Zdroj: European Heart Journal. 43
ISSN: 1522-9645
0195-668X
DOI: 10.1093/eurheartj/ehac544.431
Popis: Background Although thyroid dysfunction is a well-known complication of amiodarone treatment, population-based estimates of the short- and long-term incidence of this complication are lacking. In addition, it is not clear whether heart failure (HF) exacerbates this risk. Purpose To examine the short- and long-term incidence of thyroid dysfunction following initiation of amiodarone treatment in patients with and without HF. Methods All Danish residents who initiated amiodarone treatment between 2000–2018 without a history of thyroid dysfunction was identified using nationwide registries. Thyroid dysfunction, defined as a composite of levothyroxine, anti-thyroid medication, or a diagnosis of hypothyroidism, hyperthyroidism, or thyroiditis, was assessed at 1-year follow-up. In a landmark analysis, we estimated the 5-year outcomes with patients grouped according to the cumulated dose (CD) of amiodarone within the first year (regardless of whether treatment duration was shorter than 1 year). The Aalen-Johansen estimator and a cause-specific Cox regression model were applied to compare risk across groups. Results In total, 43,724 patients were identified of whom 16,939 (38%) had a history of HF. Compared to patients without HF, those with HF were at a similar age (71 vs 70 years), more likely men (74% vs 65%), and more often had a history of ventricular tachycardia (19% vs 6%), ischemic heart disease (60% vs 43%), aborted cardiac arrest (8.0% vs. 3.0%), ICD or CRT (30% vs 19%), all p-value 63.88 g (ADD >175 mg), (Figure 2). Conclusions In patients who initiated amiodarone treatment, around 5% had evidence of thyroid dysfunction at 1-year follow-up with a slightly higher incidence in those with a history of HF. A dose-response relationship was observed between the 1-year amiodarone cumulative dose and the subsequent 5-year cumulative incidence of thyroid dysfunction. Funding Acknowledgement Type of funding sources: None.
Databáze: OpenAIRE
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