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Region Hovedstaden - en del af Københavns Universitetshospital
E-pub ahead of print

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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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BACKGROUND: In observational studies, case reports, and animal studies, amiodarone has been associated with incident cancer.

OBJECTIVES: To examine whether a dose-response relationship between the use of amiodarone 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 (cDDD) of amiodarone. The association 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 associations between increasing amiodarone exposure (cDDD 181-400 & cDDD >400) and the hazard of incident cancer (HR 0.95, 95% CI 0.87 - 1.04 & HR 1.01, 95% CI 0.92 - 1.10) with reference to patients with a cDDD < 181. When investigating specific cancer types (skin, liver, and lung), as well as cDDD as a continuous variable, similar results were found.

CONCLUSIONS: In a large nationwide cohort of AF patients treated with amiodarone, we found no evidence of a dose-response relationship between cumulative dose of amiodarone and incident cancer risk.

OriginalsprogEngelsk
TidsskriftHeart Rhythm
ISSN1547-5271
DOI
StatusE-pub ahead of print - 29 nov. 2019

Bibliografisk note

Copyright © 2019. Published by Elsevier Inc.

ID: 58508351