| Title |
Digoxin and Mortality in Patients With Atrial Fibrillation
|
|---|---|
| Published in |
JACC, March 2018
|
| DOI | 10.1016/j.jacc.2017.12.060 |
| Pubmed ID | |
| Authors |
Renato D. Lopes, Roberto Rordorf, Gaetano M. De Ferrari, Sergio Leonardi, Laine Thomas, Daniel M. Wojdyla, Peter Ridefelt, John H. Lawrence, Raffaele De Caterina, Dragos Vinereanu, Michael Hanna, Greg Flaker, Sana M. Al-Khatib, Stefan H. Hohnloser, John H. Alexander, Christopher B. Granger, Lars Wallentin, ARISTOTLE Committees and Investigators |
| Abstract |
Digoxin is widely used in patients with atrial fibrillation (AF). The goal of this paper was to explore whether digoxin use was independently associated with increased mortality in patients with AF and if the association was modified by heart failure and/or serum digoxin concentration. The association between digoxin use and mortality was assessed in 17,897 patients by using a propensity score-adjusted analysis and in new digoxin users during the trial versus propensity score-matched control participants. The authors investigated the independent association between serum digoxin concentration and mortality after multivariable adjustment. At baseline, 5,824 (32.5%) patients were receiving digoxin. Baseline digoxin use was not associated with an increased risk of death (adjusted hazard ratio [HR]: 1.09; 95% confidence interval [CI]: 0.96 to 1.23; p = 0.19). However, patients with a serum digoxin concentration ≥1.2 ng/ml had a 56% increased hazard of mortality (adjusted HR: 1.56; 95% CI: 1.20 to 2.04) compared with those not on digoxin. When analyzed as a continuous variable, serum digoxin concentration was associated with a 19% higher adjusted hazard of death for each 0.5-ng/ml increase (p = 0.0010); these results were similar for patients with and without heart failure. Compared with propensity score-matched control participants, the risk of death (adjusted HR: 1.78; 95% CI: 1.37 to 2.31) and sudden death (adjusted HR: 2.14; 95% CI: 1.11 to 4.12) was significantly higher in new digoxin users. In patients with AF taking digoxin, the risk of death was independently related to serum digoxin concentration and was highest in patients with concentrations ≥1.2 ng/ml. Initiating digoxin was independently associated with higher mortality in patients with AF, regardless of heart failure. |
X Demographics
The data shown below were collected from the profiles of 597 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 131 | 22% |
| United States | 77 | 13% |
| Mexico | 22 | 4% |
| Venezuela, Bolivarian Republic of | 17 | 3% |
| United Kingdom | 13 | 2% |
| Argentina | 13 | 2% |
| Colombia | 11 | 2% |
| Chile | 10 | 2% |
| Ecuador | 7 | 1% |
| Other | 55 | 9% |
| Unknown | 241 | 40% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 458 | 77% |
| Practitioners (doctors, other healthcare professionals) | 79 | 13% |
| Scientists | 45 | 8% |
| Science communicators (journalists, bloggers, editors) | 14 | 2% |
| Unknown | 1 | <1% |
Mendeley readers
The data shown below were compiled from readership statistics for 252 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 252 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 27 | 11% |
| Student > Bachelor | 27 | 11% |
| Researcher | 23 | 9% |
| Student > Postgraduate | 22 | 9% |
| Student > Master | 19 | 8% |
| Other | 59 | 23% |
| Unknown | 75 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 108 | 43% |
| Pharmacology, Toxicology and Pharmaceutical Science | 25 | 10% |
| Nursing and Health Professions | 4 | 2% |
| Agricultural and Biological Sciences | 3 | 1% |
| Biochemistry, Genetics and Molecular Biology | 3 | 1% |
| Other | 15 | 6% |
| Unknown | 94 | 37% |
Attention Score in Context
This research output has an Altmetric Attention Score of 412. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 January 2023.
All research outputs
#72,610
of 25,732,188 outputs
Outputs from JACC
#170
of 16,923 outputs
Outputs of similar age
#1,779
of 345,861 outputs
Outputs of similar age from JACC
#4
of 414 outputs
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