Amiodarone-induced thyrotoxicosis: clinical course and predictors of outcome.
(2007) Journal of the american college of cardiology : JACC — Vol. 49, n° 24, p. 2350-2355 (2007)
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- This study sought to determine the clinical course and predictors of long-term outcome in patients with documented amiodarone-induced thyrotoxicosis (AIT). Amiodarone-induced thyrotoxicosis is a condition that is difficult to manage, in particular because of the long half-life of amiodarone. Data on optimal treatment for AIT are scarce. We performed a retrospective review among patients with documented AIT at a tertiary care center. Baseline characteristics, treatment received, laboratory parameters, and events during follow-up were evaluated. The predefined composite end point consisted of the following AIT-associated complications: death, heart transplantation, hospitalization for heart failure, myocardial infarction, stroke, hospitalization for arrhythmia management, or hospitalization for treatment complications. Eighty-four patients were included in the present analysis; 27 patients received prednisone for AIT. There was no difference in time to normalization of free thyroxine between those receiving and those not receiving prednisone. Long-term follow-up showed high morbidity and mortality; 47 patients (56%) reached the primary end point. Patients receiving prednisone had a worse outcome than those not receiving prednisone (p = 0.003). Although patients received prednisone for 84 +/- 65 days, curves started to separate only 12 months after the initial diagnosis. Patients with AIT have a high event rate during follow-up. Prednisone had no effect on time to normalization of thyroxine levels and was associated with an increased event rate. Importantly, AIT-related problems must be expected late, at a time when thyroid function is under control.
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Conen, D., Melly, L., Kaufmann, C., Bilz, S., Ammann, P., Schaer, B., Sticherling, C., Muller, B., & Osswald, S. (2007). Amiodarone-induced thyrotoxicosis: clinical course and predictors of outcome. Journal of the american college of cardiology : JACC, 49(24), 2350-2355. https://doi.org/10.1016/j.jacc.2007.02.054 (Original work published 2007)