OBJECTIVE: The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study showed that rhythm-control treatment of patients with atrial fibrillation (AF) offered no survival advantage over a rate-control strategy. In a subgroup analysis of that study, it was found that digoxin increased the death rate [relative risk (RR) = 1.42), but it was suggested that this may have been attributable to prescription of digoxin for patients at greater risk of death, such as those with congestive heart failure (CHF). No study has investigated a priori the effect of digoxin on mortality in patients with AF. This study aimed to address this question. METHODS: Using data from the Registry of Information and Knowledge about Swedish Heart Intensive care Admissions (RIKS-HIA), we studied the 1-year mortality among patients admitted to coronary care units with AF, CHF, or AF+CHF with or without digoxin (n = 60,764) during 1995-2003. Adjustment for differences in background characteristics and other medications and treatments was made by propensity scoring. RESULTS: Twenty percent of patients with AF without CHF in this cohort were discharged with digoxin. This group had a higher mortality rate than the corresponding group not given digoxin [adjusted RR 1.42 (95% CI 1.29-1.56)], whereas no such difference was seen among patients with CHF with or without AF, although these patients had a nearly three-times higher mortality. CONCLUSION: The results suggest that long-term therapy with digoxin is an independent risk factor for death in patients with AF without CHF.
OBJECTIVE: The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study showed that rhythm-control treatment of patients with atrial fibrillation (AF) offered no survival advantage over a rate-control strategy. In a subgroup analysis of that study, it was found that digoxin increased the death rate [relative risk (RR) = 1.42), but it was suggested that this may have been attributable to prescription of digoxin for patients at greater risk of death, such as those with congestive heart failure (CHF). No study has investigated a priori the effect of digoxin on mortality in patients with AF. This study aimed to address this question. METHODS: Using data from the Registry of Information and Knowledge about Swedish Heart Intensive care Admissions (RIKS-HIA), we studied the 1-year mortality among patients admitted to coronary care units with AF, CHF, or AF+CHF with or without digoxin (n = 60,764) during 1995-2003. Adjustment for differences in background characteristics and other medications and treatments was made by propensity scoring. RESULTS: Twenty percent of patients with AF without CHF in this cohort were discharged with digoxin. This group had a higher mortality rate than the corresponding group not given digoxin [adjusted RR 1.42 (95% CI 1.29-1.56)], whereas no such difference was seen among patients with CHF with or without AF, although these patients had a nearly three-times higher mortality. CONCLUSION: The results suggest that long-term therapy with digoxin is an independent risk factor for death in patients with AF without CHF.
Authors: V Fuster; L E Rydén; R W Asinger; D S Cannom; H J Crijns; R L Frye; J L Halperin; G N Kay; W W Klein; S Lévy; R L McNamara; E N Prystowsky; L S Wann; D G Wyse Journal: Eur Heart J Date: 2001-10 Impact factor: 29.983
Authors: K K Koh; K S Kwon; H B Park; S H Baik; S J Park; K H Lee; E J Kim; S H Kim; S K Cho; S S Kim Journal: Am J Cardiol Date: 1995-01-01 Impact factor: 2.778
Authors: Philip S Wang; Sebastian Schneeweiss; Jerry Avorn; Michael A Fischer; Helen Mogun; Daniel H Solomon; M Alan Brookhart Journal: N Engl J Med Date: 2005-12-01 Impact factor: 91.245
Authors: Giuseppe Lippi; Gian Luca Salvagno; Martina Montagnana; Giorgio Brocco; Gian Cesare Guidi Journal: Eur J Clin Pharmacol Date: 2007-09-16 Impact factor: 2.953
Authors: Mintu P Turakhia; Pasquale Santangeli; Wolfgang C Winkelmayer; Xiangyan Xu; Aditya J Ullal; Claire T Than; Susan Schmitt; Tyson H Holmes; Susan M Frayne; Ciaran S Phibbs; Felix Yang; Donald D Hoang; P Michael Ho; Paul A Heidenreich Journal: J Am Coll Cardiol Date: 2014-08-19 Impact factor: 24.094
Authors: James V Freeman; Kristi Reynolds; Margaret Fang; Natalia Udaltsova; Anthony Steimle; Niela K Pomernacki; Leila H Borowsky; Teresa N Harrison; Daniel E Singer; Alan S Go Journal: Circ Arrhythm Electrophysiol Date: 2014-11-20
Authors: Liang-Han Ling; Peter M Kistler; Jonathan M Kalman; Richard J Schilling; Ross J Hunter Journal: Nat Rev Cardiol Date: 2015-12-10 Impact factor: 32.419
Authors: Marina M Demidova; J Gustav Smith; Carl-Johan Höijer; Fredrik Holmqvist; David Erlinge; Pyotr G Platonov Journal: Eur Heart J Acute Cardiovasc Care Date: 2012-12