The present systematic review and meta- analysis of all available data sources suggest that digoxin use is associated with an increased mortality risk , particularly among patients suffering from AF
There are conflicting data regarding the effect of digoxin use on mortality in patients with atrial fibrillation ( AF ) or with congestive heart failure ( CHF ) .
The aim of this meta- analysis was to provide detailed analysis of the currently available study reports .
Digoxin reduces 30-day all-cause hospital admission in older patients with chronic systolic heart failure.
BACKGROUND Heart failure is a leading cause of hospital admission and readmission in older adults . The new United States healthcare reform law has created provisions for financial penalties for hospitals with higher than expected 30-day all-cause readmission rates for hospitalized Medicare beneficiaries aged ≥65 years with heart failure . We examined the effect of digoxin on 30-day all-cause hospital admission in older patients with heart failure and reduced ejection fraction . METHODS In the main Digitalis Investigation Group trial , 6800 ambulatory patients with chronic heart failure ( ejection fraction ≤45 % ) were r and omly assigned to digoxin or placebo . Of these , 3405 were aged ≥65 years ( mean age , 72 years ; 25 % were women ; 11 % were nonwhite ) . The main outcome in the current analysis was 30-day all-cause hospital admission . RESULTS In the first 30 days after r and omization , all-cause hospitalization occurred in 5.4 % ( 92/1693 ) and 8.1 % ( 139/1712 ) of patients in the digoxin and placebo groups , respectively , ( hazard ratio { HR } when digoxin was compared with placebo , 0.66 ; 95 % confidence interval { CI } , 0.51 - 0.86 ; P=.002 ) . Digoxin also reduced both 30-day cardiovascular ( 3.5 % vs 6.5 % ; HR , 0.53 ; 95 % CI , 0.38 - 0.72 ; P<.001 ) and heart failure ( 1.7 vs 4.2 % ; HR , 0.40 ; 95 % CI , 0.26 - 0.62 ; P<.001 ) hospitalizations , with similar trends for 30-day all-cause mortality ( 0.7 % vs 1.3 % ; HR , 0.55 ; 95 % CI , 0.27 - 1.11 ; P=.096 ) . Younger patients were at lower risk of events but obtained similar benefits from digoxin . CONCLUSIONS Digoxin  reduces 30-day all-cause hospital admission in ambulatory older patients with chronic systolic heart failure . Future studies need to examine its effect on 30-day all-cause hospital readmission in hospitalized patients with acute heart failure
The present systematic review and meta- analysis of all available data sources suggest that digoxin use is associated with an increased mortality risk , particularly among patients suffering from AF
There are conflicting data regarding the effect of digoxin use on mortality in patients with atrial fibrillation ( AF ) or with congestive heart failure ( CHF ) .
The aim of this meta- analysis was to provide detailed analysis of the currently available study reports .