Abstract 11969: Association of Amiodarone Use With Acute Pancreatitis in Patients With Atrial Fibrillation: A Nested Case-Control Study
Background: Amiodarone is an antiarrhythmic frequently used by atrial fibrillation (AF) patients. Case reports suggest that amiodarone use may cause acute pancreatitis. This potential adverse effect of amiodarone has not been explored in large studies.
Methods: We conducted a case-control study nested in the MarketScan® Research Database, which includes healthcare claims from >4 million individuals in the US. Cases were patients with non-valvular AF (NVAF) admitted to the hospital with a primary diagnosis of acute pancreatitis during the period 2007-12. We selected 5 controls with NVAF per case matched by sex, year of birth, and enrollment date in MarketScan. Information on use of amiodarone, other medications, and comorbidities were obtained from pharmacy, inpatient, and outpatient claims. Multivariable conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) of acute pancreatitis by use of amiodarone and other antiarrhythmics, as well as time since initiation and cumulative dose of amiodarone adjusting for confounders.
Results: We included 1686 cases and 8430 matched controls (39% women, 71 mean age). Ever users of amiodarone had an increased risk of acute pancreatitis compared to never users (Table). This elevated risk was higher if amiodarone was initiated within 12 months prior to the event date: multivariable OR (95%CI) 1.90 (1.44-2.49) vs 1.20 (0.89-1.64) if >12 months since initiation (p=0.02 for the difference) compared to never users. Cumulative use of amiodarone was not associated with increased risk of acute pancreatitis (p for trend among users=0.74). Use of other antiarrhythmics was not associated with acute pancreatitis risk (Table).
Conclusion: Amiodarone, but not other antiarrhythmics, was associated with increased risk of acute pancreatitis in the first year after initiation among patients with NVAF. Further research should replicate our findings and determine potential mechanisms.
Author Disclosures: A. Alonso: None. R.F. MacLehose: None. P.L. Lutsey: None. S. Konety: None. L.Y. Chen: None.
- © 2014 by American Heart Association, Inc.