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Hepatic Dysfunction in Patients Receiving Intravenous Amiodarone.
Ali Hashmi1, Nicole R Keswani1, Sharon Kim1
1From the Department of Medicine and Pharmacy Service, Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, Texas.
Southern Medical Journal
|February 4, 2016
Summary
Intravenous amiodarone (IV) can cause elevated liver enzymes in 5% of patients. While severe liver enzyme elevations occurred, deaths from amiodarone-induced liver failure were rare.
Area of Science:
- Cardiology
- Hepatology
- Pharmacology
Background:
- Amiodarone is a widely prescribed antiarrhythmic medication.
- Hepatotoxicity is a known side effect of oral amiodarone, affecting 1-3% of patients.
- Intravenous (IV) amiodarone-induced hepatotoxicity is less common but can lead to significant transaminase increases.
Purpose of the Study:
- To determine the incidence of liver toxicity in patients receiving IV amiodarone.
- To evaluate the relationship between amiodarone-induced transaminitis and 30-day mortality.
Main Methods:
- A retrospective review was conducted at a single center.
- Data from 1510 patients who received IV amiodarone between 2005 and 2011 were analyzed.
- Elevated serum transaminases and 30-day mortality were the primary outcome measures.
Main Results:
- 5% (77 out of 1510) of patients developed elevated liver enzymes.
- The median alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were 189 IU/L and 253 IU/L, respectively.
- Mortality within 30 days was 22% for patients with transaminitis, but no deaths were attributed to amiodarone-induced liver failure.
Conclusions:
- IV amiodarone can cause severe elevations in liver enzymes.
- The incidence of severe transaminitis is low.
- Deaths associated with IV amiodarone are seldom due to drug-induced liver failure.
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