Key result
Thyroidectomy improved thyroid hormone status, cardiac function, and mortality compared to optimal medical therapy in 303 patients with amiodarone-induced thyrotoxicosis, especially if LVEF < 40%.
Why the study?
The principal management of amiodarone-induced thyrotoxicosis is balancing cardiac-thyroid conditions, but the role of thyroidectomy remains contentious.
Does thyroidectomy improve thyroid hormone status, cardiac function, and mortality in patients with amiodarone-induced thyrotoxicosis compared to optimal medical therapy?
Systematic Review (n=303)
Does thyroidectomy improve thyroid hormone status, cardiac function, and mortality in patients with amiodarone-induced thyrotoxicosis compared to optimal medical therapy?
Thyroidectomy is an effective and safe treatment for amiodarone-induced thyrotoxicosis that improves cardiac function and mortality, and should be considered early rather than as a last resort.
Answers are grounded in this paper and cite their sources.
Supports early thyroidectomy in amiodarone-induced thyrotoxicosis with LVEF <40%; extends Level 1 evidence beyond observational data.
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.
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Widiarti et al. (2024) conducted a systematic review in Amiodarone-induced thyrotoxicosis (n=303). Thyroidectomy vs. Optimal medical therapy was evaluated on Thyroid hormone status, cardiac function, and mortality. Thyroidectomy improved thyroid hormone status, cardiac function, and mortality compared to optimal medical therapy in 303 patients with amiodarone-induced thyrotoxicosis, especially if LVEF < 40%.
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