Department of Anesthesiology and Critical Care, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Curr Med Chem. 2023;30(23):2690-2699. doi: 10.2174/0929867329666220831145651.
Due to the importance of amiodarone-induced hyperthyroidism in patients with heart failure, the purpose of the present systematic review and metaanalysis was to determine the prevalence of thyroid dysfunction (hypothyroidism and hyperthyroidism) in patients with heart disease who received amiodarone.
Electronic databases including Scopus, PubMed, Web of Science, and Science Direct were searched by two investigators. To assess the heterogeneity between the included studies, the chi-square χ test (α=0.05) and I index were used. Additionally, a random-effects model with 95% CI was used to estimate the pooled prevalence of thyroid dysfunction due to the heterogeneity of the studies. To identify the cause of heterogeneity, a meta-regression analysis was employed. All analyses were performed using Stata ver13 (Stata Corporation, College Station, TX, USA).
The pooled prevalence of hypothyroidism was 23.43% (95% CI: 11.54-35.33) and hyperthyroidism was 11.61% (95% CI: 7.20-16.02). There was no significant association between the prevalence of hypothyroidism and the year of the study (p=0.152), sample size (p=0.805), and mean age of subjects in the sample groups (p=0.623). However, there was a significant association between the prevalence of hyperthyroidism and the year of the study (p=0.037), but no statistically significant association between either the prevalence of hyperthyroidism and sample size (p=0.425), or the prevalence of hyperthyroidism and the mean age of subjects in the sample groups (p=0.447).
The prevalence of thyroid dysfunction in patients with cardiac arrhythmias receiving amiodarone was considerable. Extreme care should be exercised to improve the monitoring of any thyroid abnormalities that may arise in patients receiving amiodarone.
由于胺碘酮引起的甲状腺功能亢进症在心力衰竭患者中的重要性，本系统评价和荟萃分析的目的是确定接受胺碘酮治疗的心脏病患者甲状腺功能障碍（甲状腺功能减退症和甲状腺功能亢进症）的患病率。
两名研究人员通过电子数据库（Scopus、PubMed、Web of Science 和 Science Direct）进行了搜索。为了评估纳入研究之间的异质性，使用卡方 χ 检验（α=0.05）和 I 指数。此外，由于研究的异质性，使用随机效应模型和 95%CI 来估计甲状腺功能障碍的总患病率。为了确定异质性的原因，进行了荟萃回归分析。所有分析均使用 Stata ver13（Stata 公司，德克萨斯州学院站）进行。
甲状腺功能减退症的总患病率为 23.43%（95%CI：11.54-35.33），甲状腺功能亢进症的患病率为 11.61%（95%CI：7.20-16.02）。甲状腺功能减退症的患病率与研究年份（p=0.152）、样本量（p=0.805）和样本组中受试者的平均年龄（p=0.623）之间无显著关联。然而，甲状腺功能亢进症的患病率与研究年份之间存在显著关联（p=0.037），但与样本量（p=0.425）或样本组中受试者的平均年龄（p=0.447）之间无统计学显著关联。
接受胺碘酮治疗的心律失常患者甲状腺功能障碍的患病率相当高。在接受胺碘酮治疗的患者中，应格外小心，以改善对任何可能出现的甲状腺异常的监测。
