MedStar Authors catalog › Details for: Digoxin use and lower risk of 30-day all-cause readmission in older patients with heart failure and reduced ejection fraction receiving beta-blockers.
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Digoxin use and lower risk of 30-day all-cause readmission in older patients with heart failure and reduced ejection fraction receiving beta-blockers.

by Lam, Phillip H; Bhyan, Poonam; Dooley, Daniel J; Mohammed, Selma F.
Citation: Clinical Cardiology. 41(3):406-412, 2018 Mar..Journal: Clinical cardiology.Published: ; 2018ISSN: 0160-9289.Full author list: Lam PH; Bhyan P; Arundel C; Dooley DJ; Sheriff HM; Mohammed SF; Fonarow GC; Morgan CJ; Aronow WS; Allman RM; Waagstein F; Ahmed A.UI/PMID: 29569405.Subject(s): *Adrenergic beta-Antagonists/ad [Administration & Dosage] | Aged | Alabama/ep [Epidemiology] | Cardiotonic Agents/ad [Administration & Dosage] | *Digoxin/ad [Administration & Dosage] | Dose-Response Relationship, Drug | Drug Therapy, Combination | Echocardiography | Female | Follow-Up Studies | *Heart Failure/dt [Drug Therapy] | Heart Failure/mo [Mortality] | Heart Failure/pp [Physiopathology] | Heart Ventricles/dg [Diagnostic Imaging] | Heart Ventricles/de [Drug Effects] | *Heart Ventricles/pp [Physiopathology] | Hospital Mortality/td [Trends] | Humans | Male | *Patient Readmission/td [Trends] | Propensity Score | Retrospective Studies | Survival Rate/td [Trends] | Time Factors | Ventricular Function, Left/de [Drug Effects] | *Ventricular Function, Left/ph [Physiology]Institution(s): MedStar Washington Hospital Center | MedStar Heart & Vascular InstituteDepartment(s): Medicine/Internal MedicineActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1002/clc.22889 (Click here) Abbreviated citation: Clin Cardiol. 41(3):406-412, 2018 Mar.Local Holdings: Available online from MWHC library: 1976 - present, Available in print through MWHC library:1999-2007.Abstract: BACKGROUND: Digoxin use has been associated with a lower risk of 30-day all-cause admission and readmission in patients with heart failure and reduced ejection fraction (HFrEF).Abstract: HYPOTHESIS: Digoxin use will be associated with improved outcomes in patients with HFrEF receiving beta-blockers.Abstract: METHODS: Of the 3076 hospitalized Medicare beneficiaries with HFrEF (EF <45%), 1046 received a discharge prescription for beta-blockers, of which 634 were not on digoxin. Of the 634, 204 received a new discharge prescription for digoxin. Propensity scores for digoxin use, estimated for each of the 634 patients, were used to assemble a matched cohort of 167 pairs of patients receiving and not receiving digoxin, balanced on 30 baseline characteristics. Matched patients (n=334) had a mean age of 74years and were 46% female and 30% African American.Abstract: RESULTS: 30-day all-cause readmission occurred in 15% and 27% of those receiving and not receiving digoxin, respectively (hazard ratio [HR]: 0.51, 95% confidence interval [CI]: 0.31-0.83, P=0.007). This beneficial association persisted during 4years of follow-up (HR: 0.72, 95% CI: 0.57-0.92, P=0.008). Digoxin use was also associated with a lower risk of the combined endpoint of all-cause readmission or all-cause mortality at 30days (HR: 0.54, 95% CI: 0.34-0.86, P=0.009) and at 4years (HR: 0.76, 95% CI: 0.61-0.96, P=0.020).Abstract: CONCLUSIONS: In hospitalized patients with HFrEF receiving beta-blockers, digoxin use was associated with a lower risk of 30-day all-cause readmission but not mortality, which persisted during longer follow-up.Abstract: Copyright (c) 2018 Wiley Periodicals, Inc.

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