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Journal of Thyroid Research
Volume 2012, Article ID 210529, 7 pages
http://dx.doi.org/10.1155/2012/210529
Clinical Study

A Risk Prediction Index for Amiodarone-Induced Thyrotoxicosis in Adults with Congenital Heart Disease

1Department of Internal Medicine, Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
2Department of Emergency Medicine, Mayo Clinic, Rochester, MN 55905, USA
3Department of Internal Medicine, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA
4Department of Health Sciences Research, Division of Biostatistics, Mayo Clinic, Rochester, MN 55905, USA

Received 29 September 2011; Revised 17 November 2011; Accepted 18 November 2011

Academic Editor: Fausto Bogazzi

Copyright © 2012 Marius N. Stan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Amiodarone therapy in adults with congenital heart disease (CHD) is associated with a significant risk of amiodarone-induced thyrotoxicosis (AIT). We developed a risk index to identify those patients being considered for amiodarone treatment who are at high risk for AIT. We reviewed the health records of adults with CHD and assessed the association between potential clinical predictors and AIT. Significant predictors were included in multivariate analyses. The parameter estimates from multivariate analysis were subsequently used to develop a risk index. 169 adults met eligibility criteria and 23 developed AIT. The final model included age, cyanotic heart disease and BMI. The risk index developed identified 3 categories of risk. Their AIT likelihood ratios were: 0.37 for low risk (95% CI 0.15–0.92); 1.12 for medium risk (95% CI 0.65–1.91); and 3.47 for high risk (95% CI 1.7–7.11). The AIT predicted risk in our population was 5% for the low risk group, 15% for the medium risk group and 47% for the high risk group. Conclusions. We derived the first model to quantify the risk for developing AIT among adults with CHD. Before using it clinically to help selecting among alternative antiarrhythmic options, it needs validation in an independent population.