The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

An Increase in Plasma Cholesterol Independent of Thyroid Function during Long-Term Amiodarone Therapy: A Dose-Dependent Relationship

Wilmar M. Wiersinga, MD, PhD; Mieke D. Trip, MD; Mieke H. van Beeren, PhD; Theo A. Plomp, PhD; and Hans Oosting, PhD
[+] Article, Author, and Disclosure Information

Grant Support: By the Dutch Heart Foundation (grant no. 82. 052).

Requests for Reprints: Wilmar M. Wiersinga, MD, Department of Endocrinology, Academisch Medisch Centrum F5-258, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.

Current Author Addresses: Drs. Wiersinga and van Beeren: Department of Endocrinology, Academisch Medisch Centrum F5-258, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.

Dr. Trip: Department of Cardiology, Academisch Medisch Centrum F4-140, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands. Dr. Plomp: The Netherlands Institute for Drugs and Doping Research, State University of Utrecht, Vondellaan 14, Utrecht 3521 GE, The Netherlands.

Dr. Oosting: Department of Medical Physics and Informatics, Academisch Medisch Centrum, L0-57, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.

©1991 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1991;114(2):128-132. doi:10.7326/0003-4819-114-2-128
Text Size: A A A

Objective: To determine whether long-term amiodarone treatment is associated with a rise in plasma cholesterol, and, if so, to analyze its relation with thyroid function.

Design: Consecutive entry trial, including cardiac patients who initiated amiodarone medication but excluding those with abnormal thyroid function (defined as peak thyroid-stimulating hormone [TSH] response to thyrotropin-releasing hormone [TRH] < 2.8 or > 22.0 mU/L) either before or during amiodarone treatment.

Patients: Twenty-three patients who remained euthyroid were studied.

Intervention: Oral administration of amiodarone (mean duration of treatment, 17 months; range, 6 to 30 months).

Measurements: Fasting plasma lipids, thyroid hormones, and peak TSH to TRH values were recorded before and every 6 months during amiodarone treatment.

Results: Plasma cholesterol gradually increased from 5.1 ± 0.2 mmol/L before treatment to 6.9 ± 0.8 mmol/L after 30 months of amiodarone medication (P < 0.001); the peak TSH response to TRH did not change. When age- and sex-specific reference values were applied, 30% of the patients had cholesterol values above the 75th percentile before treatment; this number rose to 69% after 2 years of treatment. The rise in plasma cholesterol was associated with an equal increase in apoprotein B. Plasma cholesterol was not related to the daily dose of amiodarone or to plasma concentrations of amiodarone, desethylamiodarone, thyroxine (T4), triiodothyronine (T3), or reverse triiodothyronine (rT3). Linear regression analysis indicated a positive relation between plasma cholesterol and the cumulative dose of amiodarone (r = 0.25, P < 0.05).

Conclusion: Long-term amiodarone treatment is associated with a dose-dependent increase in plasma cholesterol that is independent of thyroid function.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.