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首页> 外文期刊>Journal of the American College of Cardiology >Amiodarone-induced thyrotoxicosis: clinical course and predictors of outcome.
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Amiodarone-induced thyrotoxicosis: clinical course and predictors of outcome.

机译：胺碘酮引起的甲状腺毒症：临床过程和预后指标。

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OBJECTIVES: This study sought to determine the clinical course and predictors of long-term outcome in patients with documented amiodarone-induced thyrotoxicosis (AIT). BACKGROUND: Amiodarone-induced thyrotoxicosis is a condition that is difficult to manage, in particular because of the long half-life of amiodarone. Data on optimal treatment for AIT are scarce. METHODS: We performed a retrospective review among patients with documented AIT at a tertiary care center. Baseline characteristics, treatment received, laboratory parameters, and events during follow-up were evaluated. The predefined composite end point consisted of the following AIT-associated complications: death, heart transplantation, hospitalization for heart failure, myocardial infarction, stroke, hospitalization for arrhythmia management, or hospitalization for treatment complications. RESULTS: Eighty-four patients were included in the present analysis; 27 patients received prednisone for AIT. There was no difference in time to normalization of free thyroxine between those receiving and those not receiving prednisone. Long-term follow-up showed high morbidity and mortality; 47 patients (56%) reached the primary end point. Patients receiving prednisone had a worse outcome than those not receiving prednisone (p = 0.003). Although patients received prednisone for 84 +/- 65 days, curves started to separate only 12 months after the initial diagnosis. CONCLUSIONS: Patients with AIT have a high event rate during follow-up. Prednisone had no effect on time to normalization of thyroxine levels and was associated with an increased event rate. Importantly, AIT-related problems must be expected late, at a time when thyroid function is under control.
机译：目的：本研究旨在确定已证明胺碘酮致甲状腺毒症（AIT）患者的临床病程和长期预后指标。背景：胺碘酮引起的甲状腺毒症是一种难以控制的疾病，尤其是由于胺碘酮的半衰期较长。关于AIT最佳治疗的数据很少。方法：我们在三级护理中心对有AIT记录的患者进行了回顾性审查。评估基线特征，接受的治疗，实验室参数以及随访期间的事件。预定义的复合终点包括以下与AIT相关的并发症：死亡，心脏移植，因心力衰竭住院，心肌梗塞，中风，因心律不齐管理而住院或因治疗并发症而住院。结果：本分析纳入84例患者。 27例患者接受泼尼松治疗AIT。接受和未接受泼尼松治疗者之间的游离甲状腺素正常化时间没有差异。长期随访显示高发病率和高死亡率。 47名患者（56％）达到了主要终点。接受泼尼松治疗的患者预后较未接受泼尼松治疗的患者差（p = 0.003）。尽管患者接受泼尼松治疗84 +/- 65天，但在初次诊断后仅12个月就开始分离曲线。结论：AIT患者在随访期间发生率较高。泼尼松对甲状腺素水平正常化的时间没有影响，并且与事件发生率增加相关。重要的是，在甲状腺功能得到控制的时候，必须迟到与AIT相关的问题。

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