Major adverse cardiac events in patients with amiodarone-induced thyrotoxicosis undergoing thyroidectomy: a multicenter study.
Pre-op ejection fraction below 40% linked to far higher 5-year cardiac events after thyroidectomy
Major adverse cardiac events in patients with amiodarone-induced thyrotoxicosis undergoing thyroidectomy: a multicenter study.
Total thyroidectomy is proposed for refractory cases, but its long-term impact on major adverse cardiovascular events (major adverse cardiovascular events) remains uncertain.
This study evaluates post-operative major adverse cardiovascular events and cardiac mortality in amiodarone-induced thyrotoxicosis patients with and without pre-operative left ventricular ejection fraction (left ventricular ejection fraction) impairment.
Undergoing total thyroidectomy for amiodarone-induced thyrotoxicosis from 2010 to 2023 in two French referral centers were retrospectively included.
worse heart outcomes when heart pumping function is reduced before surgery
Patients in group 1 were younger, had higher American Society of Anesthesia (American Society of Anesthesia) scores, and had more severe cardiac conditions.
The median duration of exposure to amiodarone-induced thyrotoxicosis was 2.7 (Q1; Q3 1.3; 4.7) months.
Overall, perioperative mortality was 2.0%.
Multivariate regression identified younger age at amiodarone-induced thyrotoxicosis diagnosis and baseline left ventricular ejection fraction < 40% as significantly associated with a higher 5-year major adverse cardiovascular events rate.
Patients with left ventricular ejection fraction < 40% carries a high long-term cardiovascular risk despite early thyroidectomy. Post-operative left ventricular ejection fraction assessment may help identify high-risk patients.
In contrast, those with left ventricular ejection fraction ≥ 40% have a favorable prognosis.