Portal de investigación
Digoxin and prognosis of heart failure in older patients with preserved ejection fraction: Importance of heart rate. Results from an observational and multicenter study.
Autores de INCLIVA
Participantes ajenos a INCLIVA
- Llàcer P
- Conde Martel A
- Cabanes Hernández Y
- Díez Manglano J
- Álvarez Rocha P
- Soler Rangel L
- Gómez Del Olmo V
- Manzano L
- Montero Pérez-Barquero M
Grupos y Plataformas de I+D+i
Abstract
Background: The value of digoxin in heart failure (HF) remains controversial, particularly in patients with preserved ejection fraction (HFpEF). This study evaluated the 1-year risk of events after digoxin treatment for acute heart failure (AHF) in patients > 70 years old with HFpEF. Methods: 1833 patients were included in this analysis (mean age, 82 years). The main endpoints were all-cause death and the composite of death and/or HF re-admission within 1 year. Cox regression analysis was used to evaluate the association between digoxin treatment and prognosis. Results: 401 patients received digoxin treatment; of these, 86% had atrial fibrillation. The mean baseline heart rate was 86 +/- 22 bpm. At the 1-year follow-up, 375 patients (20.5%) died and 684 (37.3%) presented composite endpoints. Patients treated with digoxin showed higher rates of death (3.21 vs. 2.44 per 10 person-years, p = .019) and composite endpoint (6.72 vs. 5.18 per 10 person-years, p = .003). After multivariate adjustment, digoxin treatment remained associated with increased risks of death (HR = 1.46, 95% CI: 1.16-1.85, p = .001) and the composite endpoint (HR = 1.35, 95% CI: 1.13-1.61, p = .001). A distinctive prognostic effect of digoxin was found across the heart rate continuum; the risks for both endpoints were higher at lower heart rates and neutral at higher heart rates (p of the interactions = 0.007 and 0.03, respectively). Conclusions: In older patients with HFpEF discharged after AHF, digoxin treatment was associated with increased mortality and/or re-admission, particularly in patients with lower heart rates.
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved
Datos de la publicación
- ISSN/ISSNe:
- 0953-6205, 1879-0828
- Tipo:
- Article
- Páginas:
- 18-23
- PubMed:
- 30360944
European Journal of Internal Medicine ELSEVIER SCIENCE BV
Citas Recibidas en Web of Science: 15
Documentos
- No hay documentos
Filiaciones
Keywords
- Digoxin; Heart failure; Prognosis
Financiación
Proyectos y Estudios Clínicos
INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER
Investigador Principal: JUAN SANCHIS FORES
CB16/11/00420 . INSTITUTO SALUD CARLOS III
Cita
Llàcer P,Núñez J,Bayés A,Conde A,Cabanes Y,Díez J,Álvarez P,Soler L,Gómez Del Olmo V,Manzano L,Montero Pérez M. Digoxin and prognosis of heart failure in older patients with preserved ejection fraction: Importance of heart rate. Results from an observational and multicenter study. Eur. J. Intern. Med. 2019. 60. p. 18-23. IF:4,329. (1).
Digoxin and prognosis of heart failure in older patients with preserved ejection fraction: Importance of heart rate. Results from an observational and multicenter study. Llàcer P, Núñez J, Bayés A, Conde A, Cabanes Y, Díez J, Álvarez P et al. European Journal of Internal Medicine. 2019 febrero 01. 6018-23. DOI:10.1016/j.ejim.2018.10.010. PMID:30360944.
