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Related Experiment Videos

Thyroid function abnormalities during amiodarone therapy for persistent atrial fibrillation.

Elizabeth L Batcher1, X Charlene Tang, Bramah N Singh

  • 1West Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif, USA. batcherb@gmail.com

The American Journal of Medicine
|October 2, 2007
PubMed
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Amiodarone therapy significantly increases hypothyroidism risk in males, with over 30% developing the condition. This thyroid dysfunction often appears early in treatment, highlighting the need for monitoring amiodarone patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Amiodarone is frequently prescribed, yet its long-term impact on thyroid function in male patients remains under-researched.
  • Thyroid dysfunction is a known potential side effect of amiodarone treatment.

Purpose of the Study:

  • To prospectively evaluate the incidence and characteristics of amiodarone-induced thyroid dysfunction in a large cohort of male patients.
  • To compare thyroid function in amiodarone-treated males versus a control group.

Main Methods:

  • A substudy of the prospective randomized SAFE-Trial, comparing amiodarone, sotalol, and placebo for persistent atrial fibrillation.
  • Serial thyroid function tests (TSH) were conducted over 1-4.5 years in 612 male patients.
  • Sotalol and placebo groups were combined as controls.

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Main Results:

  • Hypothyroidism (TSH 4.5-10 mU/L) occurred in 25.8% of amiodarone patients vs. 6.6% of controls (P <.0001).
  • Overt hypothyroidism (TSH >10 mU/L) affected 5.0% of amiodarone patients vs. 0.3% of controls (P <.001).
  • Hyperthyroidism (TSH <0.35 mU/L) showed a trend towards higher incidence in the amiodarone group (5.3% vs 2.4%, P=.07).

Conclusions:

  • Amiodarone significantly increases the risk of hypothyroidism in older males, affecting 30.8% compared to 6.9% in controls.
  • Thyroid dysfunction, particularly hypothyroidism, manifests early in amiodarone therapy.
  • While hyperthyroidism was observed, it was predominantly subclinical.