%0 Journal Article
%T Amiodarone-Induced Cirrhosis of Liver: What Predicts Mortality?
%A Nasir Hussain
%A Anirban Bhattacharyya
%A Suartcha Prueksaritanond
%J ISRN Cardiology
%D 2013
%R 10.1155/2013/617943
%X Introduction. Amiodarone has been used for more than 5 decades for the treatment of various tachyarrhythmias and previously for the treatment of refractory angina. There are multiple well-established side effects of amiodarone. However, amiodarone-induced cirrhosis (AIC) of liver is an underrecognized complication. Methods. A systematic search of Medline from January 1970 to November 2012 by using the following terms, amiodarone and cirrhosis, identified 37 reported cases of which 30 were used in this analysis. Patients were divided into 2 subsets, survivors versus nonsurvivors, at 5 months. Results. Aspartate aminotransferase was significantly lower ( ) in patients who survived at 5-months (mean 103.33£¿IU/L) compared to nonsurvivors (mean 216.88£¿IU/L). There was no statistical difference in the levels of prothrombin time, total bilirubin, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, cumulative dose, and latency period between the two groups. The prevalence of DM, HTN, HLD, CAD, and CHF was similar in the two groups. None of the above-mentioned variables could be identified as a predictor of survival at 5 months. Conclusion. AIC carries a mortality risk of 60% at 5 months once the diagnosis is established. Further prospective studies are needed to identify predictors of AIC and of mortality or survival in cases of AIC. 1. Introduction Amiodarone has been used since the 1960s for the management of various tachyarrhythmias and in the past for refractory angina. There are multiple reported and well-established side effects of amiodarone therapy such as effects on the thyroid, skin, lungs, nerves, and cornea. The effect of amiodarone on the liver resulting in hepatotoxicity is a recognized complication of amiodarone, but this hepatotoxicity leading to cirrhosis of the liver is unfortunately an underrecognized side effect. Little has been written on amiodarone-induced cirrhosis (AIC) of the liver due to its rarity [1¨C4]. The purpose of this paper is to review what we know so far about AIC of the liver. 2. Materials and Methods 2.1. Selection of Studies A systematic search of Medline from January 1970 to November 2012 by using the following terms, amiodarone and cirrhosis, was performed; 37 reported cases were identified (Table 1) of which 30 were used in this analysis. We also searched the reference lists of all reported cases to identify citations that were not identified during the initial search. Data that were extracted for each patient included age, gender, latency period in years, whether ¡Ý200£¿mg/day amiodarone dosage
%U http://www.hindawi.com/journals/isrn.cardiology/2013/617943/