TY  - BOOK
AU  - Bhyan, Poonam
AU  - Dooley, Daniel J
AU  - Lam, Phillip H
AU  - Mohammed, Selma F
TI  - Digoxin use and lower risk of 30-day all-cause readmission in older patients with heart failure and reduced ejection fraction receiving beta-blockers
SN  - 0160-9289
PY  - 2018///
KW  - *Adrenergic beta-Antagonists/ad [Administration & Dosage]
KW  - *Digoxin/ad [Administration & Dosage]
KW  - *Heart Failure/dt [Drug Therapy]
KW  - *Heart Ventricles/pp [Physiopathology]
KW  - *Patient Readmission/td [Trends]
KW  - *Ventricular Function, Left/ph [Physiology]
KW  - Aged
KW  - Alabama/ep [Epidemiology]
KW  - Cardiotonic Agents/ad [Administration & Dosage]
KW  - Dose-Response Relationship, Drug
KW  - Drug Therapy, Combination
KW  - Echocardiography
KW  - Female
KW  - Follow-Up Studies
KW  - Heart Failure/mo [Mortality]
KW  - Heart Failure/pp [Physiopathology]
KW  - Heart Ventricles/de [Drug Effects]
KW  - Heart Ventricles/dg [Diagnostic Imaging]
KW  - Hospital Mortality/td [Trends]
KW  - Humans
KW  - Male
KW  - Propensity Score
KW  - Retrospective Studies
KW  - Survival Rate/td [Trends]
KW  - Time Factors
KW  - Ventricular Function, Left/de [Drug Effects]
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Medicine/Internal Medicine
KW  - Journal Article
N1  - Available online from MWHC library: 1976 - present, Available in print through MWHC library:1999-2007
N2  - 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); 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; Copyright (c) 2018 Wiley Periodicals, Inc; HYPOTHESIS: Digoxin use will be associated with improved outcomes in patients with HFrEF receiving beta-blockers; 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; 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)
UR  - https://dx.doi.org/10.1002/clc.22889
ER  -