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Increased mortality risk for AF patients on digoxin, independent of heart failure

Digoxin use is associated with a higher risk of all-cause mortality in patients aged ≥65 years with atrial fibrillation (AF) regardless of concomitant heart failure (HF), according to a retrospective analysis published recently in the American Journal of Cardiology.1

Previous studies on digoxin use in patients with AF and the risk of all-cause mortality found conflicting results. The authors conducted a population-based retrospective cohort study of patients aged ≥65 years admitted to a hospital with a primary or secondary diagnosis of AF, in Quebec province, Canada from 1998 to 2012. The AF cohort was grouped into patients with and without HF and into digoxin and no-digoxin users according to the first prescription filled for digoxin within 30 days after AF hospital discharge.

They derived propensity score matched digoxin and no-digoxin treatment groups for the groups of patients with and without HF, respectively and conducted multivariable Cox-proportional hazards regression analyses to determine association between digoxin use and all-cause mortality. The AF propensity score matched cohorts of patients with and without HF, were well balanced on baseline characteristics.

In the propensity score matched HF group, digoxin use was associated with a 14% higher risk of all-cause mortality (adjusted hazard ratio (HR): 1.14, 95% confidence interval (CI): 1.10 to 1.17). In the propensity score matched no-HF group, digoxin use was associated with a 17% higher risk of all-cause mortality (adjusted HR: 1.17, 95% CI: 1.14 to 1.19).

References

1. Shah M, Tsadok MA, Jackevicius CA, Essebag V, Behlouli H, Pilote L. Relation of digoxin use in atrial fibrillation and the risk of all-cause mortality in patients ≥65 years of age with versus without heart failure. Am J Cardiol 2014. http://dx.doi.org/10.1016/j.amjcard.2014.05.013

Published on: June 26, 2014

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ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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