Actividad Investigadora
Digoxin initiation after an acute heart failure episode and its association with post-discharge outcomes: an international multicenter analysis
Autores de IDIVAL
Autores ajenos al IDIVAL
- Miró, O
- Mojarro, EM
- Huré, G
- Llorens, P
- Gil, V
- Alquézar-Arbé, A
- Bibiano, C
- González, NC
- Massó, M
- Strebel, I
- Espinosa, B
- Masó, SM
- Wussler, D
- Shrestha, S
- Lopez-Ayala, P
- Jacob, J
- Millán, J
- Andueza, JA
- Pàmies, SL
- Cerdà, JF
- Martínez, CP
- Herrero, P
- Peacock, WF
- Mueller, C
- ICA SEMES
- CRIB Res Grp
Unidades
Abstract
Digoxin is commonly used to treat acute heart failure (AHF), especially in patients with concurrent atrial fibrillation (AF). Nonetheless, there is little consensus about in which patients digoxin should be given, the proper time for digoxin initiation, and whether digoxin initiation is associated with improved outcomes. We investigated factors related to digoxin initiation after an episode of AHF and whether patients receiving digoxin presented better short-term outcomes. We analyzed digoxinna & iuml;ve AHF patients from a Spanish and Swiss database, who were dichotomized into cohorts based on their receipt of digoxin treatment at discharge. The relationship between digoxin initiation and 23 additional patient covariates, including chronic treatment, was investigated, as well as its association with 90-day combined adverse events (defined as all-cause death or AHF hospitalization). Of 13,105 patients (10,600/2505 from the Spanish/Swiss cohorts, respectively), the median (inter- quartile range) age was 83 (74.87) years, and 51% were women. Of these, 484 (3.7%) received digoxin at discharge, which was associated with AF, female sex, left ventricular ejection fraction (LVEF) < 50%, and coming from the Spanish cohort. Parameters inversely associated with receiving digoxin at discharge included some chronic treatments, diabetes mellitus (DM), and chronic kidney disease (CKD). Digoxin initiation was not association with 90-day adverse events, adjusted hazard ratio (aHR) = 0.939 (0.769-1.146), but there was an interaction for CKD, aHR = 1.390 (0.831-2.325) vs. 0.854 (0.682-1.183), p = 0.039, and for cohort pertinence, with higher risk in the Swiss cohort; aHR = 1.405 (0.827-2.386) vs. 0.862 (0.689-1.077), p = 0.046. Digoxin initiation after an AHF episode was more frequent in the Spanish cohort and was associated with certain patient characteristics (AF, female sex, reduced LVEF, no DM, no CKD), but had no effect on 90-day outcomes.
Datos de la publicación
- ISSN/ISSNe:
- 1970-9366, 1970-9366
- Tipo:
- Article
- Páginas:
- 65-76
- PubMed:
- 39174687
Internal and Emergency Medicine SPRINGER-VERLAG ITALIA SRL
Citas Recibidas en Web of Science: 2
Documentos
- No hay documentos
Filiaciones
Keywords
- Acute heart failure; Atrial fibrillation; Outcome; Mortality; Hospitalization
Cita
Miró O, Mojarro EM, Huré G, Llorens P, Gil V, Alquézar A, Bibiano C, González NC, Massó M, Strebel I, Espinosa B, Masó SM, Wussler D, Shrestha S, Lopez P, Jacob J, Millán J, Andueza JA, Alonso H, Pàmies SL, Cerdà JF, Martínez CP, Herrero P, Peacock WF, Mueller C, ICA S, CRIB GRP. Digoxin initiation after an acute heart failure episode and its association with post-discharge outcomes: an international multicenter analysis. Intern Emerg Med. 2025. 20. (1):p. 65-76. IF:3,800. (1).
