BACKGROUND: In the main Digitalis Investigation Group (DIG) trial, digoxin reduced the risk of 30-day all-cause hospitalization in older systolic heart failure patients. However, this effect has not been studied in older diastolic heart failure patients. METHODS: In the ancillary DIG trial, of the 988 patients with chronic heart failure and preserved (> 45%) ejection fraction, 631 were age ≥ 65 years (mean age 73 years, 45% women, 12% non-whites), of whom 311 received digoxin. RESULTS: All-cause hospitalization 30-day post randomization occurred in 4% of patients in the placebo group and 9% each among those in the digoxin group receiving 0.125 mg and ≥ 0.25 mg a day dosage (P = .026). Hazard ratios (HR) and 95% confidence intervals (CI) for digoxin use overall for 30-day, 3-month, and 12-month all-cause hospitalizations were 2.46 (1.25-4.83), 1.45 (0.96-2.20) and 1.14 (0.89-1.46), respectively. There was one 30-day death in the placebo group. Digoxin-associated HRs (95% CIs) for 30-day hospitalizations due to cardiovascular, heart failure, and unstable angina causes were 2.82 (1.18-6.69), 0.51 (0.09-2.79), and 6.21 (0.75-51.62), respectively. Digoxin had no significant association with 30-day all-cause hospitalization among younger patients (6% vs 7% for placebo; HR 0.80; 95% CI, 0.36-1.79). CONCLUSIONS: In older patients with chronic diastolic heart failure, digoxin increased the risk of 30-day all-cause hospital admission, but not during longer follow-up. Although chance finding due to small sample size is possible, these data suggest that unlike in systolic heart failure, digoxin may not reduce 30-day all-cause hospitalization in older diastolic heart failure patients. Published by Elsevier Inc.
RCT Entities:
BACKGROUND: In the main Digitalis Investigation Group (DIG) trial, digoxin reduced the risk of 30-day all-cause hospitalization in older systolic heart failurepatients. However, this effect has not been studied in older diastolic heart failurepatients. METHODS: In the ancillary DIG trial, of the 988 patients with chronic heart failure and preserved (> 45%) ejection fraction, 631 were age ≥ 65 years (mean age 73 years, 45% women, 12% non-whites), of whom 311 received digoxin. RESULTS: All-cause hospitalization 30-day post randomization occurred in 4% of patients in the placebo group and 9% each among those in the digoxin group receiving 0.125 mg and ≥ 0.25 mg a day dosage (P = .026). Hazard ratios (HR) and 95% confidence intervals (CI) for digoxin use overall for 30-day, 3-month, and 12-month all-cause hospitalizations were 2.46 (1.25-4.83), 1.45 (0.96-2.20) and 1.14 (0.89-1.46), respectively. There was one 30-day death in the placebo group. Digoxin-associated HRs (95% CIs) for 30-day hospitalizations due to cardiovascular, heart failure, and unstable angina causes were 2.82 (1.18-6.69), 0.51 (0.09-2.79), and 6.21 (0.75-51.62), respectively. Digoxin had no significant association with 30-day all-cause hospitalization among younger patients (6% vs 7% for placebo; HR 0.80; 95% CI, 0.36-1.79). CONCLUSIONS: In older patients with chronic diastolic heart failure, digoxin increased the risk of 30-day all-cause hospital admission, but not during longer follow-up. Although chance finding due to small sample size is possible, these data suggest that unlike in systolic heart failure, digoxin may not reduce 30-day all-cause hospitalization in older diastolic heart failurepatients. Published by Elsevier Inc.
Authors: Ali Ahmed; Michael W Rich; Thomas E Love; Donald M Lloyd-Jones; Inmaculada B Aban; Wilson S Colucci; Kirkwood F Adams; Mihai Gheorghiade Journal: Eur Heart J Date: 2005-12-08 Impact factor: 29.983
Authors: Ali Ahmed; Michael W Rich; Jerome L Fleg; Michael R Zile; James B Young; Dalane W Kitzman; Thomas E Love; Wilbert S Aronow; Kirkwood F Adams; Mihai Gheorghiade Journal: Circulation Date: 2006-07-24 Impact factor: 29.690
Authors: M Iriarte; R Caso; N Murga; J M Faus; D Sagastagoitia; E Molinero; M López de Argumedo; J Boveda Journal: Am J Cardiol Date: 1995-02-15 Impact factor: 2.778
Authors: Adrian F Hernandez; Bradley G Hammill; Christopher M O'Connor; Kevin A Schulman; Lesley H Curtis; Gregg C Fonarow Journal: J Am Coll Cardiol Date: 2009-01-13 Impact factor: 24.094
Authors: Ali Ahmed; Robert C Bourge; Gregg C Fonarow; Kanan Patel; Charity J Morgan; Jerome L Fleg; Inmaculada B Aban; Thomas E Love; Clyde W Yancy; Prakash Deedwania; Dirk J van Veldhuisen; Gerasimos S Filippatos; Stefan D Anker; Richard M Allman Journal: Am J Med Date: 2013-11-18 Impact factor: 4.965
Authors: Raya E Kheirbek; Ross D Fletcher; Marie A Bakitas; Gregg C Fonarow; Sridivya Parvataneni; Donna Bearden; Frank A Bailey; Charity J Morgan; Steven Singh; Marc R Blackman; Michael R Zile; Kanan Patel; Momanna B Ahmed; Rodney O Tucker; Cynthia J Brown; Thomas E Love; Wilbert S Aronow; Jeffrey M Roseman; Michael W Rich; Richard M Allman; Ali Ahmed Journal: Circ Heart Fail Date: 2015-05-27 Impact factor: 8.790
Authors: Daya Ram Parajuli; Sepehr Shakib; Joanne Eng-Frost; Ross A McKinnon; Gillian E Caughey; Dean Whitehead Journal: BMC Cardiovasc Disord Date: 2021-02-18 Impact factor: 2.298
Authors: Oliver J Ziff; Deirdre A Lane; Monica Samra; Michael Griffith; Paulus Kirchhof; Gregory Y H Lip; Richard P Steeds; Jonathan Townend; Dipak Kotecha Journal: BMJ Date: 2015-08-30