A retrospective study on amiodarone pulmonary toxicity in Chinese patients in Hong Kong

Abstract

Background and Aim:Amiodarone is one of the most commonlyused anti-arrhythmic agents in atrial and ventricular arrhythmias. Amiodar-one pulmonary toxicity is a potentially fatal adverse effect associated withamiodarone use. Previous studies on the epidemiology and risk factors foramiodarone pulmonary toxicity showed diverse results. The objective ofthis study is to identify clinico-epidemiologic markers associated with amio-darone pulmonary toxicity in a cohort with defined amiodarone exposure.Methods:List of patients taking amiodarone who were managed inQueen Mary Hospital and Grantham Hospital from 2005 to 2015 wasretrieved. Those who fulfilled the inclusion criteria were obtained and ana-lyzed on the risk factors associated with amiodarone pulmonary toxicity.Results:A total of 25 cases with amiodarone pulmonary toxicity wereidentified among 1113 patients taking amiodarone for at least 90 days from2005 to 2015. The incidence of amiodarone pulmonary toxicity was esti-mated to be 2.2% The risk factors for amiodarone pulmonary toxicityincluded increase in age (OR 1.044, 95% CI 1.008 - 1.082, p = 0.016), ven-tricular arrhythmia (OR 2.757, 95% CI 1.262–6.024, p = 0.011), underlyinglung disease (OR 3.885, 95% CI 1.584–9.528, p = 0.003) and cumulativedose of amiodarone (OR 5.457, 95% CI 1.515–19.660 p = 0.009).Conclusion:The incidence of amiodarone pulmonary toxicity in Chi-nese patients in Hong Kong is estimated to be 2.2% in this study. Age,underlying lung disease, ventricular arrhythmia and cumulative dose ofamiodarone are associated with the development of amiodarone pulmo-nary toxicity. It is worth conducting a prospective clinical study in future tovalidate the findings observed in this study. Acknowledgements: I am grateful for the kind assistance and advice regarding statistical analysis from Mr. Dr. Hei Man Herbert Pang.