P1192Is all hypothyroidism in patients on amiodarone caused by the drug or is a some simply a consequence of the intensive monitoring of TSH in an at risk population?
Notice bibliographique
Résumé
Background: Hypothyroidism is common in the elderly. In the CHS, 16.5% of patients over the age of 65 years (mean age 72.7years) were diagnosed with hypothyroidism. The Canadian Thyroid Foundation has stated that 15% of Canadians >65 years have hypothyroidism and 24% entering a nursing home are diagnosed with or treated for hypothyroidism. Amiodarone is a very effective anti-arrhythmic agent but with potentially serious adverse reactions. Physicians familiar with the drug, accept hypothyroidism as a frequent consequence of Amiodarone therapy. Amiodarone is an Iodine based with a similar structure to Thyroxine. Thyroid abnormalities are a logical consequence of Amiodarone. The purpose of our investigation was to see if all hypothyroidism developed while on Amiodarone is due to the drug? Methods: Our database was searched for patients who had been prescribed Amiodarone. These were then compared to a similar (age and gender) cohort of coronary disease patients who had never been prescribed Amiodarone or any other anti-arrhythmic drug. In the control group, patients with any form of arrhythmia, valvular disease, pacemaker or previous ablation were excluded. Patients were diagnosed with hypothyroidism if they were taking thyroid medication. The unpaired t-test was used to determine differences between means and the Fischer’s exact test was used to determine differences between proportions. A P value <0.05 was considered statistically significant. Results: There were 360 Patients in both the Amiodarone and the control groups. The groups were well matched for Age (80.3±11.4 vs 80.9±7.3 years, P=0.4006) and Gender (M/F 221/139 vs 227/133, P=0.7008). There were 105 patients (29%) in the Amiodarone group who were taking thyroid replacement compared to 83 patients (23%) in the control group, (P=0.0746). On reviewing the TSH levels in 51 patients with normal baseline TSH and not already taking Thyroid replacement at baseline there were two distinct patterns, Group 1: 18 patients developed an elevated TSH requiring treatment within the first year, with most increases in TSH occurring in the first 6 months. Another 3 patients developed a high TSH during the second year. Group 2: 30 patients developed an elevated TSH requiring treatment ranging from 3-16 years following Amiodarone treatment with mean time of 7.1 ± 3.8 years and a median of 6 years. If one just considers the late development of hypothyroidism, there were 84/360 in the Amiodarone group and 83/360 in the control group, (P =NS, Fischer’s exact test). Conclusion: The early development of hypothyroidism during Amiodarone therapy is drug related. It is much less likely that the late development of hypothyroidism is related to Amiodarone, more likely it is just the emergence of a disease which is common in the elderly and which is diagnosed because of the intensive monitoring of thyroid function that occurs during Amiodarone monitoring.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».