title: Obesity Is Associated With the Development of Interstitial Pneumonia Under Long-Term Administration of Amiodarone in Refractory Atrial Fibrillation Patients.
abstract: Although oral amiodarone (AMD) has been used for the management of atrial fibrillation (AF), serious complications such as interstitial pneumonia (IP) occur very occasionally. We evaluated which factors were associated with the development of IP under the long-term administration of AMD in patients with refractory AF.This study included 122 consecutive patients (65.8 ± 11.4 years, mean body mass index [BMI] of 23.2 ± 4.3 kg/m(2)) who orally received AMD to inhibit AF between January 2004 and December 2013. Administration of AMD was begun at 400 mg daily as a loading dose, and was continued at a dosage of 50-400 mg daily after the initial loading phase, determined by the control of the arrhythmias and occurrence of side-effects. The clinical factors were compared between the patients with and without adverse effects, especially IP.During an average follow-up period of 49.2 ± 28.2 months, 53 patients (43.4%) were determined to have converted and maintained sinus rhythm. In contrast, adverse effects were detected in 46 patients (37.7%) with AMD. IP occurred in 8 patients (6.6%), thyrotoxicosis in 35 (28.7%), and others in 5 (4.1%). Four (50.0%) out of 8 patients complicated with IP had obesity (BMI > 27 kg/m(2)). Among the clinical factors, only obesity was significantly associated with the development of IP (P = 0.026).In patients with refractory AF, AMD had an antiarrhythmic effect with long-term administration, but greater adverse effects were also observed. Obesity was the most significant factor associated with the development of IP.
authors.affiliation: Department of Cardiovascular Medicine, Toho University Faculty of Medicine.
authors.forename: Hideki
authors.initials: H
authors.lastname: Koike
authors.forename: Tadashi
authors.initials: T
authors.lastname: Fujino
authors.forename: Makiko
authors.initials: M
authors.lastname: Koike
authors.forename: Masaya
authors.initials: M
authors.lastname: Shinohara
authors.forename: Ken
authors.initials: K
authors.lastname: Kitahara
authors.forename: Toshio
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Hitomi
authors.initials: H
authors.lastname: Yuzawa
authors.forename: Takeya
authors.initials: T
authors.lastname: Suzuki
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sato
authors.forename: Shunji
authors.initials: S
authors.lastname: Fukunaga
authors.forename: Kenzaburo
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Takanori
authors.initials: T
authors.lastname: Ikeda
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000008:administration & dosage* / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000209:etiology; D015992:Body Mass Index; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000209:etiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone