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 <181. Similar results were found when investigating specific cancer types (skin, liver, and lung) as well as cDDD as a continuous variable. CONCLUSION: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.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Rasmussen PV,Dalgaard F,Hilmar Gislason G,Torp-Pedersen C,Piccini J,D'Souza M,Ruwald MH,Pallisgaard JL,Hansen MLdoi
10.1016/j.hrthm.2019.11.025subject
Has Abstractpub_date
2020-04-01 00:00:00pages
560-566issue
4eissn
1547-5271issn
1556-3871pii
S1547-5271(19)31088-4journal_volume
17pub_type
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