Association of Amiodarone Use With Acute Pancreatitis in Patients With Atrial Fibrillation: A Nested Case-Control Study | Journal Scan

Study Questions:

Is amiodarone treatment for atrial fibrillation (AF) associated with acute pancreatitis?


Patients with nonvalvular AF who were admitted to the hospital with a primary diagnosis of acute pancreatitis (cases) were matched (by sex, year of birth, and others, in a 1:5 ratio) against patients with nonvalvular AF, but without pancreatitis (controls). Data regarding medications and comorbidities were collected for both groups. Multivariable logistic regression was used to calculate odds ratios of acute pancreatitis related to amiodarone and other antiarrhythmic drugs (AADs).


The authors identified 1,686 cases and 8,430 controls. There was a much higher prevalence of biliary disease (42% vs. 4%), alcoholism (5% vs. 1%), and prior pancreatic disease (21% vs. 1%) among cases as compared with controls. Case patients were more likely to have been treated with amiodarone (14.5%) than controls (9%) (odds ratio, 1.5; 95% confidence interval, 1.2-1.9).


The authors concluded that treatment with amiodarone, as compared to other AADs, was associated with acute pancreatitis in patients with AF.


Amiodarone is associated with a wide variety of adverse effects, some of which are serious, and potentially life-threatening. Acute pancreatitis is also a serious condition, but one that is rarely encountered by cardiologists, electrophysiologists, and cardiac surgeons in patients who are taking amiodarone. A recent case-control study from Taiwan also implicated amiodarone in patients who were currently taking the drug. Taken together, amiodarone use may be associated with acute pancreatitis, but this risk is likely to be quite small. In the absence of more definitive data, periodic surveillance for this condition is probably not warranted.

Clinical Topics: Arrhythmias and Clinical EP, EP Basic Science, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Amiodarone, Anti-Arrhythmia Agents, Atrial Fibrillation, Pancreatitis, Comorbidity, Case-Control Studies, Logistic Models

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