Mortality and morbidity of heart failure treated with digoxin. A propensity-matched study: Digoxin and heart failure
Open accessAbstract
BACKGROUND: The role of digoxin in the prognosis of patients with heart failure (HF) remains unclear. AIMS: To evaluate the relationship of commencing treatment with digoxin (CTDig) with the mortality and the morbidity of patients with HF. METHODS: Prospective study over 8 years on 4467 patients with HF. Main outcomes were all-cause and cardiovascular mortality, hospitalisations and visits. We analyse the independent relationship of CTDig, with the mortality and the morbidity, stratifying patients for cardiovascular comorbidity, after propensity score-matching for potential confounders (1421 patients who CTDig vs. another 1421 patients non-exposed to digoxin). RESULTS: During a median follow up of 46.1 months, 1872 patients (65.9%) died, and 2203 (77.5%) were hospitalised. CTDig was associated with a lower all-cause mortality (HR = 0.90 [95% CI, 0.84-0.97]), and cardiovascular mortality (HR = 0.87 [0.81-0.96]), hospitalisation (HR = 0.91 [0.86-0.97]), 30-day readmission for HF (HR = 0.88 [0.79-0.95]), and visits (HR = 0.94 [0.90-0.98]) (p < 0.001 in all cases), after adjustment for the propensity to take digoxin, other medications, and other potential confounders. These effects of digoxin were independent of gender, or type of HF (systolic or non-systolic). CONCLUSION: The data suggest that therapy with digoxin is associated with an improved mortality and morbidity of HF, including women and patients with non-systolic HF.
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The association between digoxin use and excess mortality in AF patients is likely due to selection and prescription biases rather than harm caused by digoxin, particularly as digoxin is commonly prescribed to sicker patients.
“Observational studies have associated digoxin use with excess mortality in AF patients, [547][548][549] but this association is likely due to selection and prescription biases rather than harm caused by digoxin, [550][551][552][553] particularly as digoxin is commonly prescribed to sicker patients.225”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [552]
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
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Observational cohort study of the safety of digoxin use in women with heart failure
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- Authors
- Andrey, J. L., Romero, S., García-Egido, A., Escobar, M. A., Corzo, R., Garcia-Dominguez, G., Lechuga, V., & Gómez, F.
- Affiliations
- Universidad de Cádiz (ES)
- Venue
- International Journal of Clinical Practice
- Publisher
- Hindawi Limited
- Published
- 2011-11-17
- Volume
- 65
- Issue
- 12
- Pages
- 1250-1258
- ISSN
- 1368-5031 (ISSN-L)
- OpenAlex
- W1491928200
- Cited by
- 27
- References
- 29
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 4 · 2015: 2 · 2014: 2 · 2013: 1 · 2012: 2
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- digoxin, heart failure, all-cause mortality, cardiovascular mortality, hospitalization, heart failure readmission, morbidity, women
- MeSH terms
- Aged, Cardiotonic Agents, Digoxin, Female, Heart Failure, Humans, Male, Prospective Studies, Treatment Outcome, Kaplan-Meier Estimate, Propensity Score
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