Acute Amiodarone Pulmonary Toxicity After Surgical Procedures

Teerakanok, Jirapat; Tantrachoti, Pakpoom; Chariyawong, Phumpattra; Nugent, Kenneth

doi:10.1016/j.amjms.2016.08.013

Cited by 21 publications

(13 citation statements)

References 35 publications

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“…In this current study, we found no statistically significant increased risk for patients who had amiodarone prophylaxis in the RASCABG regime. Furthermore, we found no statistically significant difference in the risk of readmission, late AF or long-term mortality within prophylactic groups, indicating that amiodarone may be less hazardous than previous alleged [17] In current studies, POAF has been associated with an increased risk of late AF, and long-term mortality [5] [22] [23] [24]. Despite corresponding findings of the competing risk regression and survival analysis, POAF was not associated with an increased risk of late AF, and long-term mortality in the adjusted Cox regression analysis of our study.…”

Section: Discussioncontrasting

confidence: 53%

“…In the multivariable analysis, no associations were found within subgroups regarding late AF, readmission or long-term mortality. The use of amiodarone has previously been associated with a number of short-term side effects and more serious adverse effects including skin cancer and toxicity of lung, thyroid and liver [17] [18] [19] [20] [21]. In this current study, we found no statistically significant increased risk for patients who had amiodarone prophylaxis in the RASCABG regime.…”

Section: Discussioncontrasting

confidence: 44%

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Amiodarone Prophylaxis for Atrial Fibrillation after Coronary Bypass—12 Years Follow-Up

Enevoldsen¹,

Borregaard

Riber

et al. 2020

OJTS

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Objectives: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery and might be avoided with amiodarone prophylaxis. We investigated the long-term effect of prophylactic amiodarone, in patients undergoing isolated, elective coronary artery bypass grafting (CABG), as well as the long-term prognosis of patients with POAF. Methods: We retrospectively analysed patients included in the randomized, control trial RASCABG allocated to either placebo or amiodarone as POAF prophylaxis. Several outcomes were evaluated using national databases. Patients were stratified and compared by prophylactic groups and rhythm. Cox proportional hazard analysis was used for multivariable analysis. Kaplan-Meier survival curves were constructed to assess the probability of survival and cumulative incidence curves. Results: Prophylactic amiodarone was not related to long-term side effects in comparison to placebo. Patients who developed POAF, were more likely to develop late AF, and had a worse overall survival. There was no difference in the overall survival between prophylactic groups. In the competing risk analysis, amiodarone and POAF was not associated with an increased risk of readmission, but POAF was associated with an increased risk of late AF HR 2.28 [95% CI 1.15; 4.55]. In the multivariable analysis, amiodarone was not associated with late AF, readmission or long-term mortality. Further, no association was found between POAF and late AF, readmission or long-term mortality. Conclusion: Amiodarone is a safe drug for the prevention of POAF in the RASCABG-setting. POAF is related to long-term worse prognosis regarding late AF and mortality.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussioncontrasting

confidence: 44%

Amiodarone Prophylaxis for Atrial Fibrillation after Coronary Bypass—12 Years Follow-Up

Enevoldsen¹,

Borregaard

Riber

et al. 2020

OJTS

View full text Add to dashboard Cite

show abstract

“…The use of amiodarone has previously been associated with a number of short-term side effects and more serious adverse effects including skin cancer and toxicity of lung, thyroid and liver [18] [19] [20] [21] [22]. In this current study, we found no statistically significant increased risk for patients who had amiodarone prophylaxis in the PASCART regime.…”

Section: Discussioncontrasting

confidence: 44%

Amiodarone for Postoperative Atrial Fibrillation in Lung Cancer Patients: A 6-Year Follow-Up Study

Enevoldsen¹,

Borregaard

Riber

et al. 2020

OJTS

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Background: The preventive effect of prophylactic amiodarone on postoperative atrial fibrillation (POAF) in patients undergoing thoracic surgery has previously been demonstrated. Meanwhile, the long-term effect remains unknown. We investigated the long-term effect of prophylactic amiodarone, in patients undergoing surgery for lung cancer, along with the long-term prognosis of patients with POAF within 6 years of follow-up. Methods: Using data from national databases, we retrospectively analysed 250 patients included and randomized, in the randomized control trial, PASCART, in which patients were allocated to receive either amiodarone or placebo as prophylaxis for POAF. Prophylactic groups, and subgroups, were compared on a number of outcomes. Long-term overall survival was evaluated using Kaplan-Meier survival curves, and Cox proportional hazards models were used for multivariable analysis. Competing risk analysis was used to evaluate time-to-event data in presence of competing risk. Results: When comparing the prophylactic groups, prophylaxis with amiodarone was not convincingly related to a higher frequency of long-term side effects. Patients who developed POAF, were more likely to develop late atrial fibrillation (AF) and POAF was associated with an increased risk of late AF in both the competing risk analysis hazard rate (HR) 4.80 [95% 1.75; 13.18] and multivariable analysis of the Cox regression, HR 5.03 [95% 1.80; 14.10]. When comparing the Kaplan Meier survival curves between groups, we found no statistically significant difference in the long-term overall survival. Conclusions: Intravenous prophylactic amiodarone is safe in patients undergoing lung cancer surgery. POAF is associated with an increased risk of late AF.

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“…Risk factors of our patient were age, pre-existing lung disease and a daily dose of pneumonectomy patients. However, in a recent study by Teerakanok et al the incidence of amiodarone induced postoperative (mostly after cardiothoracic surgery) ARDS was reported to be 15% [22]. The possible mechanisms are high oxygen administration, lung damage of intubation/ventilation, the systemic inflammatory response induced by surgery.…”

Section: Discussionmentioning

confidence: 99%

Amiodarone Induced Pulmonary Toxicity: A Fatal Case Report

Gülmez¹,

Ozsancak²

2017

J Clin Case Rep

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Amiodarone Induced Pulmonary Toxicity (AIPT) is a rare but one of the most serious adverse event that can be potentially life threatening. The incidence of AIPT is 2% to 10% and mortality rate ranges from 10% to 50% in patients who develop Acute Respiratory Distress Syndrome (ARDS). Age, preexisting lung disease, cumulative dose, thoracic surgery and pulmonary angiography are the risk factors associated with AIPT. Although there is no pathognomonic clinical, laboratory, radiographic or histological findings the diagnosis depends on clinical suspicion and exclusion of other possibilities of pulmonary disease. We present a case of 77-year-old man who presented with symptoms of pneumonia and diagnosed as AIPT by the elimination method for specific and non-specific pulmonary infection. Despite discontinuation of amiodarone and systemic therapy with corticosteroids the patient continued worsen. Pre-existing lung disease, the rapid onset of the clinical picture and the extent of lung injury on CT were the poor prognostic factors for our patient.

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Acute Amiodarone Pulmonary Toxicity After Surgical Procedures

Cited by 21 publications

References 35 publications

Amiodarone Prophylaxis for Atrial Fibrillation after Coronary Bypass—12 Years Follow-Up

Amiodarone Prophylaxis for Atrial Fibrillation after Coronary Bypass—12 Years Follow-Up

Amiodarone for Postoperative Atrial Fibrillation in Lung Cancer Patients: A 6-Year Follow-Up Study

Amiodarone Induced Pulmonary Toxicity: A Fatal Case Report

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