ナガラ　キミコ   Nagara Kimiko   長柄　希実子    所属   医学部 医学科（東京女子医科大学病院）    職種   助手
言語種別	日本語
発表タイトル	Impact of Thyroid Dysfunction on Mortality in Patients Receiving Amiodarone
会議名	第79回日本循環器学会学術集会
主催者	日本循環器学会
学会区分	全国規模の学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎山田隆弘, 鈴木敦, 志賀剛, 長柄希実子, 飛田尚重, 芹澤直紀, 鈴木豪, 萩原誠久
発表年月日	2015/04/26
開催地 （都市, 国名）	大阪市
学会抄録	PROGRAM JCS 2015 782
概要	Objective: Amiodarone is a benzofuranic iodine-rich drug. Previous reports indicate that amiodarone causes many adverse effects including amiodarone induced thyrotoxicosis (AIT) and hypothyroidism (AIH) in 14-18% of patients. We examined the association between thyroid function and mortality in patients receiving amiodarone. Methods: We conducted a retrospective cohort study comprising 764 patients (age: 57±16, 77% male) treated with amiodarone in our hospital between 1990 and 2010. Baseline free triiodothyronine (FT3), free thyoxine (FT4), and thyroid-stimulating hormone (TSH) were measured before amiodarone treatment. AIT was defined as serum thyroid stimulating hormone (TSH) <0.01 µU/ml and AIH was defined as serum TSH >20 µU/ml. Results: Total 153 (20%) patients developed thyroid dysfunction; 45 patients developed AIT, 91 patients developed AIH and 18 patients developed both. Baseline TSH (HR 1.15, 95% CI 1.07-1.23, p<0.001) and FT4 (HR 0.28, 95% CI 0.12-0.67, p<0.01) were associated with AIH but other parameters did not predict AIT or AIH. There was no difference in mortality between patients with and without thyroid dysfunction. Multivariate analysis showed that lower FT3 (HR 1.93, 95% CI 1.50-2.49, P<0.05) as well as older age (HR 1.03, 95% CI 1.02-1.05, p<0.05) and lower left ventricular ejection fraction (HR 1.02, 95% CI 1.01-1.03, P<0.05) were independent risks of mortality.Conclusion: Our results showed that baseline FT3 level was associated with mortality in patients receiving amiodarone.