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Antiarrhythmic agents and the risk of malignant neoplasm of liver and intrahepatic bile ducts.

Lim YP, Lin CL, Lin YN, Ma WC, Chen WC, Hung DZ, Kao CH - PLoS ONE (2015)

Bottom Line: In subgroup analysis, amiodarone use was significantly associated with an increased risk of MNLIHD with an adjusted OR of 18.0 (95% CI, 15.7-20.5) for patients with comorbidities compared to an OR of 2.43 (95% CI, 1.92-3.06) for those without comorbidities.After adjustment for age, sex, statins, anti-diabetes medications, non-steroidal antiinflammatory drugs, propafenone use, quinidine use, and comorbidities, the ORs were 1.49, 1.66, and 1.79 for MNLIHD associated with annual mean defined daily doses of ≤ 30, 31-145, and >145, respectively.The results of the present study indicated that amiodarone might be associated with the development of MNLIHD in a dose-dependent manner, particularly among patients with comorbidities.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan; Department of Emergency, Toxicology Center, China Medical University Hospital, Taichung, Taiwan.

ABSTRACT

Background: The objective of this study was to determine the association between the use of antiarrhythmic agents and the risk of malignant neoplasm of liver and intrahepatic bile ducts (MNLIHD).

Methods: We used the research database of the Taiwan National Health Insurance Program to conduct a population-based, case-control study. We identified 9944 patients with antiarrhythmic history who were first diagnosed as having MNLIHD between 2005 and 2010. We identified an additional 19,497 patients with antiarrhythmic history in the same period who did not develop MNLIHD and were frequency-matched using age, sex, and index year to form a control group. Five commercially available antiarrhythmic agents, amiodarone, mexiletine, propafenone, quinidine, and procainamide, were analyzed.

Results: The adjusted odds ratio (OR) of MNLIHD was 1.60 (95% confidence interval [CI], 1.45-1.77) for amiodarone users versus nonamiodarone users. In subgroup analysis, amiodarone use was significantly associated with an increased risk of MNLIHD with an adjusted OR of 18.0 (95% CI, 15.7-20.5) for patients with comorbidities compared to an OR of 2.43 (95% CI, 1.92-3.06) for those without comorbidities. After adjustment for age, sex, statins, anti-diabetes medications, non-steroidal antiinflammatory drugs, propafenone use, quinidine use, and comorbidities, the ORs were 1.49, 1.66, and 1.79 for MNLIHD associated with annual mean defined daily doses of ≤ 30, 31-145, and >145, respectively.

Conclusions: The results of the present study indicated that amiodarone might be associated with the development of MNLIHD in a dose-dependent manner, particularly among patients with comorbidities.

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Flow chart of participant recruitment in this study.
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pone.0116960.g001: Flow chart of participant recruitment in this study.

Mentions: Fig. 1 illustrated the sampling scheme in the study. From the Registry of Catastrophic Illness and NHI program databases, we identified arrhythmia (ICD-9-CM codes 426–427) patients newly diagnosed with MNLIHD (ICD-9-CM code 155) in the period from 2005 to 2010 as a case group. Patients who were younger than 20 years of age were excluded. The date of application for MNLIHD was defined as the index date. For each of the MNLIHD patients, we randomly selected 2 arrhythmia patients without MNLIHD from the same period, using the same exclusion criteria, and frequency-matched the case group by using sex and age (5 y a group). A total of 9944 patients with MNLIHD and 19,497 patients without MNLIHD were included in this study.


Antiarrhythmic agents and the risk of malignant neoplasm of liver and intrahepatic bile ducts.

Lim YP, Lin CL, Lin YN, Ma WC, Chen WC, Hung DZ, Kao CH - PLoS ONE (2015)

Flow chart of participant recruitment in this study.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4295889&req=5

pone.0116960.g001: Flow chart of participant recruitment in this study.
Mentions: Fig. 1 illustrated the sampling scheme in the study. From the Registry of Catastrophic Illness and NHI program databases, we identified arrhythmia (ICD-9-CM codes 426–427) patients newly diagnosed with MNLIHD (ICD-9-CM code 155) in the period from 2005 to 2010 as a case group. Patients who were younger than 20 years of age were excluded. The date of application for MNLIHD was defined as the index date. For each of the MNLIHD patients, we randomly selected 2 arrhythmia patients without MNLIHD from the same period, using the same exclusion criteria, and frequency-matched the case group by using sex and age (5 y a group). A total of 9944 patients with MNLIHD and 19,497 patients without MNLIHD were included in this study.

Bottom Line: In subgroup analysis, amiodarone use was significantly associated with an increased risk of MNLIHD with an adjusted OR of 18.0 (95% CI, 15.7-20.5) for patients with comorbidities compared to an OR of 2.43 (95% CI, 1.92-3.06) for those without comorbidities.After adjustment for age, sex, statins, anti-diabetes medications, non-steroidal antiinflammatory drugs, propafenone use, quinidine use, and comorbidities, the ORs were 1.49, 1.66, and 1.79 for MNLIHD associated with annual mean defined daily doses of ≤ 30, 31-145, and >145, respectively.The results of the present study indicated that amiodarone might be associated with the development of MNLIHD in a dose-dependent manner, particularly among patients with comorbidities.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan; Department of Emergency, Toxicology Center, China Medical University Hospital, Taichung, Taiwan.

ABSTRACT

Background: The objective of this study was to determine the association between the use of antiarrhythmic agents and the risk of malignant neoplasm of liver and intrahepatic bile ducts (MNLIHD).

Methods: We used the research database of the Taiwan National Health Insurance Program to conduct a population-based, case-control study. We identified 9944 patients with antiarrhythmic history who were first diagnosed as having MNLIHD between 2005 and 2010. We identified an additional 19,497 patients with antiarrhythmic history in the same period who did not develop MNLIHD and were frequency-matched using age, sex, and index year to form a control group. Five commercially available antiarrhythmic agents, amiodarone, mexiletine, propafenone, quinidine, and procainamide, were analyzed.

Results: The adjusted odds ratio (OR) of MNLIHD was 1.60 (95% confidence interval [CI], 1.45-1.77) for amiodarone users versus nonamiodarone users. In subgroup analysis, amiodarone use was significantly associated with an increased risk of MNLIHD with an adjusted OR of 18.0 (95% CI, 15.7-20.5) for patients with comorbidities compared to an OR of 2.43 (95% CI, 1.92-3.06) for those without comorbidities. After adjustment for age, sex, statins, anti-diabetes medications, non-steroidal antiinflammatory drugs, propafenone use, quinidine use, and comorbidities, the ORs were 1.49, 1.66, and 1.79 for MNLIHD associated with annual mean defined daily doses of ≤ 30, 31-145, and >145, respectively.

Conclusions: The results of the present study indicated that amiodarone might be associated with the development of MNLIHD in a dose-dependent manner, particularly among patients with comorbidities.

Show MeSH
Related in: MedlinePlus