Generic placeholder image

Current Medicinal Chemistry

Editor-in-Chief

ISSN (Print): 0929-8673
ISSN (Online): 1875-533X

Systematic Review Article

Prevalence of Amiodarone Induced Hypothyroidism and Hyperthyroidism in Patients with Heart Diseases: A Systematic Review and Meta-Analysis

Author(s): Farshid Rahimi-Bashar, Amir Vahedian-Azimi*, Sahar Dalvand, Leila Karimi, Maryam Moshkani, Yousef Alimohamadi, Thomas P. Johnston and Amirhossein Sahebkar*

Volume 30, Issue 23, 2023

Published on: 24 October, 2022

Page: [2690 - 2699] Pages: 10

DOI: 10.2174/0929867329666220831145651

Price: $65

Abstract

Background: Due to the importance of amiodarone-induced hyperthyroidism in patients with heart failure, the purpose of the present systematic review and metaanalysis was to determine the prevalence of thyroid dysfunction (hypothyroidism and hyperthyroidism) in patients with heart disease who received amiodarone.

Methods: Electronic databases including Scopus, PubMed, Web of Science, and Science Direct were searched by two investigators. To assess the heterogeneity between the included studies, the chi-square χ2 test (α=0.05) and I2 index were used. Additionally, a random-effects model with 95% CI was used to estimate the pooled prevalence of thyroid dysfunction due to the heterogeneity of the studies. To identify the cause of heterogeneity, a meta-regression analysis was employed. All analyses were performed using Stata ver13 (Stata Corporation, College Station, TX, USA).

Results: The pooled prevalence of hypothyroidism was 23.43% (95% CI: 11.54-35.33) and hyperthyroidism was 11.61% (95% CI: 7.20-16.02). There was no significant association between the prevalence of hypothyroidism and the year of the study (p=0.152), sample size (p=0.805), and mean age of subjects in the sample groups (p=0.623). However, there was a significant association between the prevalence of hyperthyroidism and the year of the study (p=0.037), but no statistically significant association between either the prevalence of hyperthyroidism and sample size (p=0.425), or the prevalence of hyperthyroidism and the mean age of subjects in the sample groups (p=0.447).

Conclusion: The prevalence of thyroid dysfunction in patients with cardiac arrhythmias receiving amiodarone was considerable. Extreme care should be exercised to improve the monitoring of any thyroid abnormalities that may arise in patients receiving amiodarone.

Keywords: Amiodarone, thyroid dysfunction, heart failure, meta-analysis

« Previous
[1]
Van Herendael, H.; Dorian, P. Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia. Vasc. Health Risk Manag., 2010, 6, 465-472.
[PMID: 20730062]
[2]
Goldschlager, N.; Epstein, A.E.; Naccarelli, G.V.; Olshansky, B.; Singh, B.; Collard, H.R.; Murphy, E. A practical guide for clinicians who treat patients with amiodarone 2007. Heart Rhythm, 2007, 4(9), 1250-1259.
[http://dx.doi.org/10.1016/j.hrthm.2007.07.020] [PMID: 17765636]
[3]
Narayana, S.K.; Woods, D.R.; Boos, C.J. Management of amiodarone-related thyroid problems. Ther. Adv. Endocrinol. Metab., 2011, 2(3), 115-126.
[http://dx.doi.org/10.1177/2042018811398516] [PMID: 23148177]
[4]
Mikosch, P. Thyroid and treatment with amiodarone diagnosis, therapy and clinical management. Viennese Medical Weekly (1946), 2008, 158(1-2), 29-35.
[5]
Daniels, G.H. Amiodarone-induced thyrotoxicosis. J. Clin. Endocrinol. Metab., 2001, 86(1), 3-8.
[http://dx.doi.org/10.1210/jcem.86.1.7119] [PMID: 11231968]
[6]
Harjai, K.J.; Licata, A.A. Effects of amiodarone on thyroid function. Ann. Intern. Med., 1997, 126(1), 63-73.
[http://dx.doi.org/10.7326/0003-4819-126-1-199701010-00009] [PMID: 8992925]
[7]
Iudica-Souza, C.; Burch, H.B. Amiodarone-induced thyroid dysfunction. Endocrinologist, 1999, 9(3), 216-238.
[http://dx.doi.org/10.1097/00019616-199905000-00008]
[8]
Ahmed, S.; Van Gelder, I.C.; Wiesfeld, A.C.; Van Veldhuisen, D.J.; Links, T.P. Determinants and outcome of amiodarone-associated thyroid dysfunction. Clin. Endocrinol. (Oxf.), 2011, 75(3), 388-394.
[http://dx.doi.org/10.1111/j.1365-2265.2011.04087.x] [PMID: 21535072]
[9]
Borowski, G.D.; Garofano, C.D.; Rose, L.I.; Spielman, S.R.; Rotmensch, H.R.; Greenspan, A.M.; Horowitz, L.N. Effect of long-term amiodarone therapy on thyroid hormone levels and thyroid function. Am. J. Med., 1985, 78(3), 443-450.
[http://dx.doi.org/10.1016/0002-9343(85)90336-5] [PMID: 3976702]
[10]
Zhong, B.; Wang, Y.; Zhang, G.; Wang, Z. Environmental iodine content, female sex and age are associated with new-onset amiodarone-induced hypothyroidism: A systematic review and meta-analysis of adverse reactions of amiodarone on the thyroid. Cardiology, 2016, 134(3), 366-371.
[http://dx.doi.org/10.1159/000444578] [PMID: 27100205]
[11]
Glynn, L. EBLIP critical appraisal checklist., 2006. Available from: www.nihsie/pdf/EBL%20Critical%20Appraisal%
[12]
Glynn, L. A critical appraisal tool for library and information research. Libr. Hi Tech., 2006, 24(3), 387-399.
[http://dx.doi.org/10.1108/07378830610692154]
[13]
Yamato, M.; Wada, K.; Fujimoto, M.; Hosomi, K.; Hayashi, T.; Oita, A.; Takada, M. Association between N-desethylamiodarone/amiodarone ratio and amiodarone-induced thyroid dysfunction. Eur. J. Clin. Pharmacol., 2017, 73(3), 289-296.
[http://dx.doi.org/10.1007/s00228-017-2195-5] [PMID: 28083650]
[14]
Huang, C.J.; Chen, P.J.; Chang, J.W.; Huang, D.F.; Chang, S.L.; Chen, S.A.; Jap, T.S.; Lin, L.Y. Amiodarone-induced thyroid dysfunction in Taiwan: A retrospective cohort study. Int. J. Clin. Pharm., 2014, 36(2), 405-411.
[http://dx.doi.org/10.1007/s11096-013-9910-9] [PMID: 24515549]
[15]
Kinoshita, S.; Hayashi, T.; Wada, K.; Yamato, M.; Kuwahara, T.; Anzai, T.; Fujimoto, M.; Hosomi, K.; Takada, M. Risk factors for amiodarone-induced thyroid dysfunction in Japan. J. Arrhythm., 2016, 32(6), 474-480.
[http://dx.doi.org/10.1016/j.joa.2016.03.008] [PMID: 27920832]
[16]
Takeuchi, D; Honda, K; Shinohara, T; Inai, K; Toyohara, K; Nakanishi, T. Incidence, clinical course, and risk factors of amiodarone-induced thyroid dysfunction in Japanese adults with congenital heart disease. Circ. J., 2015, 79(8), 1828-34.
[17]
Yamamoto, J.; Katz, P.M.; Bras, J.A.; Shafer, L.A.; Cordova, F.J. Amiodarone-induced thyrotoxicosis in systolic heart failure–A retrospective cohort study. Can. J. Diabetes, 2015, 39(6), 540.
[http://dx.doi.org/10.1016/j.jcjd.2015.09.054]
[18]
Uchida, T.; Kasai, T.; Takagi, A.; Sekita, G.; Komiya, K.; Takeno, K.; Shigihara, N.; Shimada, K.; Miyauchi, K.; Fujitani, Y.; Daida, H.; Watada, H. Prevalence of amiodarone-induced thyrotoxicosis and associated risk factors in Japanese patients. Int. J. Endocrinol., 2014, 2014, 534904.
[http://dx.doi.org/10.1155/2014/534904] [PMID: 25053942]
[19]
Stan, M.N.; Hess, E.P.; Bahn, R.S.; Warnes, C.A.; Ammash, N.M.; Brennan, M.D.; Thapa, P.; Montori, V.M. A risk prediction index for amiodarone-induced thyrotoxicosis in adults with congenital heart disease. J. Thyroid Res., 2012, 2012, 210529.
[http://dx.doi.org/10.1155/2012/210529] [PMID: 22518347]
[20]
Kim, M.H.; Smith, P.J.; Jhaveri, M.; Lin, J.; Klingman, D. One-year treatment persistence and potential adverse events among patients with atrial fibrillation treated with amiodarone or sotalol: A retrospective claims database analysis. Clin. Ther., 2011, 33(11), 1668-1681.e1.
[http://dx.doi.org/10.1016/j.clinthera.2011.10.005] [PMID: 22108302]
[21]
Yiu, K.H.; Jim, M.H.; Siu, C.W.; Lee, C.H.; Yuen, M.; Mok, M.; Shea, Y.F.; Fan, K.; Tse, H.F.; Chow, W.H. Amiodarone-induced thyrotoxicosis is a predictor of adverse cardiovascular outcome. J. Clin. Endocrinol. Metab., 2009, 94(1), 109-114.
[http://dx.doi.org/10.1210/jc.2008-1907] [PMID: 18940876]
[22]
Shiga, T.; Wakaumi, M.; Matsuda, N.; Shoda, M.; Hagiwara, N.; Sato, K.; Kasanuki, H. Amiodarone-Induced thyroid dysfunction and ventricular tachyarrhythmias during long-term therapy in Japan. Jpn. Circ. J., 2001, 65(11), 958-960.
[http://dx.doi.org/10.1253/jcj.65.958] [PMID: 11716246]
[23]
Newnham, H.H.; Topliss, D.J.; Le Grand, B.A.; Chosich, N.; Harper, R.W.; Stockigt, J.R. Amiodarone-induced hyperthyroidism: Assessment of the predictive value of biochemical testing and response to combined therapy using propylthiouracil and potassium perchlorate. Aust. N.Z.J. Med., 1988, 18(1), 37-44.
[http://dx.doi.org/10.1111/j.1445-5994.1988.tb02237.x] [PMID: 2840057]
[24]
Huang, C.C.; Chen, Y.C.; Chen, L.K.; Hwang, S.J.; Lin, H.D. Relationship between age and serum thyrotropin among asymptomatic older people in Taiwan. Arch. Gerontol. Geriatr., 2010, 51(2), 117-120.
[http://dx.doi.org/10.1016/j.archger.2009.09.004] [PMID: 19819570]
[25]
Zosin, I.; Balaş, M. Amiodarone-induced thyroid dysfunction in an iodine-replete area: Epidemiological and clinical data. Endokrynol. Pol., 2012, 63(1), 2-9.
[PMID: 22378090]
[26]
Trip, M.D.; Wiersinga, W.; Plomp, T.A. Incidence, predictability, and pathogenesis of amiodarone-induced thyrotoxicosis and hypothyroidism. Am. J. Med., 1991, 91(5), 507-511.
[http://dx.doi.org/10.1016/0002-9343(91)90187-3] [PMID: 1951413]
[27]
Lee, KF; Lee, KM; Fung, TT Amiodarone-induced thyroid dysfunction in the Hong Kong Chinese population. Hong Kong Med. J., 2010, 16(6), 434-9.
[28]
Martino, E.; Aghini-Lombardi, F.; Mariotti, S.; Bartalena, L.; Braverman, L.; Pinchera, A. Amiodarone: A common source of iodine-induced thyrotoxicosis. Horm. Res., 1987, 26(1-4), 158-171.
[http://dx.doi.org/10.1159/000180696] [PMID: 2885251]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy