March 06, 2018
Digoxin use is associated with an increased risk of mortality among patients with atrial fibrillation (AF) with and without heart failure (HF), according to a recent study.
For their study, the researchers evaluated 17,987 patients with AF, comparing new digoxin users (n = 5824) with propensity-score-matched controls. The association between serum digoxin concentration and mortality was also assessed.
Ultimately, findings demonstrated that new digoxin users had a significantly higher risk of mortality (adjusted hazard ratio [HR] 1.78) and sudden death (adjusted HR 2.14) compared with controls.
Although no association was observed between baseline digoxin use and increased mortality risk (adjusted HR 1.09), a 56% higher risk of mortality was observed in patients with a serum digoxin concentration of at least 1.2 ng/ml (adjusted HR 1.56) compared with non-digoxin-users.
Furthermore, when assessed as a continuous variable, serum digoxin concentration was found to be associated with a 19% higher adjusted risk of mortality for each 0.5-ng/ml increase, regardless of HF status.
“In patients with AF taking digoxin, the risk of death was independently related to serum digoxin concentration and was highest in patients with concentrations [of at least 1.2 ng/ml],” the researchers concluded. “Initiating digoxin was independently associated with higher mortality in patients with AF, regardless of heart failure.”
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