The roles of thyroidectomy in patients with amiodarone-induced thyrotoxicosis: A systematic review

Curr Probl Cardiol. 2024 Mar;49(3):102395. doi: 10.1016/j.cpcardiol.2024.102395. Epub 2024 Jan 16.

Abstract

The principal management of Amiodarone-induced-thyrotoxicosis (AIT) is balancing cardiac-thyroid conditions. However, the role of thyroidectomy is still contentious. This systematic review aims to provide insights into the roles of thyroidectomy in the management of AIT. This systematic review encompasses 303 AIT patients who underwent thyroidectomy from 14 studies. The indication of thyroidectomy can be due to cardiac factors, thyrotoxicosis conditions, and patient-physician considerations. Thyroidectomy is more effective in improving thyroid hormone status, cardiac function, and mortality compared to optimal medical therapy, especially in those with left ventricular ejection fraction < 40 %. Thyroidectomy is effective in improving cardiac function and mortality due to shorter duration for achieving euthyroid. Thyroidectomy and medical therapy have comparable side effects. However, the identification of high-risk patients may reduce thyroidectomy complications. Thus, thyroidectomy should not be viewed as the last resource and should be performed immediately when indicated.

Keywords: Amiodarone; Cardiovascular disease; Side effect; Thyroidectomy; Thyrotoxicosis.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Amiodarone* / adverse effects
  • Anti-Arrhythmia Agents* / adverse effects
  • Anti-Arrhythmia Agents* / therapeutic use
  • Humans
  • Thyroidectomy* / methods
  • Thyrotoxicosis* / chemically induced
  • Thyrotoxicosis* / surgery

Substances

  • Amiodarone
  • Anti-Arrhythmia Agents