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Amiodarone treatment in atrial fibrillation and the risk of incident cancers: A nationwide observational study

Authors :
Morten Lock Hansen
Frederik Dalgaard
Jannik Langtved Pallisgaard
Gunnar Gislason
Jonathan P. Piccini
Maria D'Souza
Peter Vestergaard Rasmussen
Christian Torp-Pedersen
M. H. Ruwald
Source :
Rasmussen, P V, Dalgaard, F, Gislason, G H, Torp-Pedersen, C, Piccini, J, D'Souza, M, Ruwald, M H, Pallisgaard, J L & Hansen, M L 2020, ' Amiodarone treatment in atrial fibrillation and the risk of incident cancers : a nationwide observational study ', Heart Rhythm, vol. 17, no. 4, pp. 560-566 . https://doi.org/10.1016/j.hrthm.2019.11.025
Publication Year :
2020
Publisher :
Elsevier BV, 2020.

Abstract

Background: In observational studies, case reports, and animal studies, amiodarone has been associated with incident cancer. Objective: The purpose of this study was to examine whether a dose–response relationship between amiodarone use and the risk of cancer could be ascertained in a large nationwide study cohort. Methods: Using nationwide registers, we included all Danish patients with atrial fibrillation (AF) treated with amiodarone from 1996 to 2014. Exposure was defined both by categories and as a continuous variable of the cumulative defined daily doses (cDDDs) of amiodarone. The associations between amiodarone cDDD and incident cancer, as well as organ-specific types of cancer (skin, liver, lung), were estimated using multivariable Cox regression models and reported as hazard ratios (HR) with 95% confidence intervals (CI) and using cubic restricted spline plots. Results: We included 18,503 patients with a median follow-up time of 8.1 years (interquartile range [IQR] 4.3–12.4). Median age was 70 years (IQR 63–77). A total of 2974 individuals developed cancer during follow-up. We found no association between increasing amiodarone exposure (cDDD 181–400 and cDDD >400) and the hazard of incident cancer (HR 0.95; 95% CI 0.87–1.04; and HR 1.01; 95% CI 0.92–1.10) with reference to patients with cDDD

Details

ISSN :
15475271
Volume :
17
Database :
OpenAIRE
Journal :
Heart Rhythm
Accession number :
edsair.doi.dedup.....ea49ccfd12f1303b532928eb6a5e8eea
Full Text :
https://doi.org/10.1016/j.hrthm.2019.11.025