Related Experiment Videos

Mortality and morbidity of heart failure treated with digoxin. A propensity-matched study

J L Andrey1, S Romero, A García-Egido

  • 1Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.

International Journal of Clinical Practice
|November 19, 2011
PubMed

Insights

Digoxin treatment in heart failure (HF) patients is linked to better survival and fewer hospitalizations. This study confirms digoxin

Area of Science:

  • Cardiology
  • Clinical Pharmacology
  • Heart Failure Management

Background:

  • The prognostic impact of digoxin in heart failure (HF) patients is not well-established.
  • Existing research presents conflicting evidence regarding digoxin's benefits in HF management.

Purpose of the Study:

  • To investigate the association between initiating digoxin treatment (CTDig) and patient outcomes in heart failure.
  • To evaluate the impact of CTDig on all-cause mortality, cardiovascular mortality, and morbidity events.

Main Methods:

  • A prospective, 8-year study involving 4467 heart failure patients.
  • Propensity score-matching was used to compare 1421 patients who commenced digoxin treatment with 1421 similar patients who did not.
  • Outcomes analyzed included all-cause and cardiovascular mortality, hospitalizations, and healthcare visits.

Main Results:

  • Commencing digoxin treatment was associated with significantly lower all-cause mortality (HR=0.90) and cardiovascular mortality (HR=0.87).
  • Digoxin use correlated with reduced hospitalizations (HR=0.91), 30-day HF readmissions (HR=0.88), and healthcare visits (HR=0.94).
  • These benefits were consistent across different patient subgroups, including women and those with non-systolic heart failure.

Conclusions:

  • Digoxin therapy appears to improve both mortality and morbidity in heart failure patients.
  • The positive effects of digoxin were observed independently of patient gender or HF type (systolic vs. non-systolic).
  • These findings support the continued use of digoxin in selected heart failure populations.
Abstract

Related Concept Videos

Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...