Digoxin and mortality in atrial fibrillation: a prospective cohort study

@article{Hallberg2007DigoxinAM,
  title={Digoxin and mortality in atrial fibrillation: a prospective cohort study},
  author={P{\"a}r Hallberg and Johan Lindb{\"a}ck and Bertil Lindahl and Ulf Stenestrand and H{\aa}kan Melhus and for the Sinphoni Group},
  journal={European Journal of Clinical Pharmacology},
  year={2007},
  volume={63},
  pages={959-971}
}
ObjectiveThe Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study showed that rhythm-control treatment of patients with atrial fibrillation (AF) offered no survival advantage over a rate-control strategy. In a subgroup analysis of that study, it was found that digoxin increased the death rate [relative risk (RR) = 1.42), but it was suggested that this may have been attributable to prescription of digoxin for patients at greater risk of death, such as those with… Expand
Digoxin in atrial fibrillation: report from the Stockholm Cohort study of Atrial Fibrillation (SCAF)
TLDR
Digoxin is mainly given to an elderly and frailer subset of patients withAF and is thus associated with an increased mortality and when differences in patient characteristics are accounted for digoxin use seems to have a neutral effect on mortality and major cardiovascular events in patients with AF. Expand
Impact of Digoxin on Mortality in Patients With Atrial Fibrillation Stratified by Heart Failure
TLDR
In patients with AF and HF, digoxin did not offer any survival advantages, however, in those without HF, diggingoxin therapy was, in fact, associated with significantly higher long-term mortality. Expand
( SCAF ) Stockholm Cohort study of Atrial Fibrillation Digoxin in atrial fibrillation : report from the
Background Recent studies of patients with heart failure and of patients receiving intensive care indicate that digoxin may increase mortality if the patient has atrial fibrillation (AF). ObjectiveExpand
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TLDR
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Does digoxin increase the risk of ischemic stroke and mortality in atrial fibrillation? A nationwide population-based cohort study.
TLDR
Digoxin should be avoided for patients with AF without heart failure because it was associated with an increased risk of clinical events, and β-Blockers may be a better choice for controlling ventricular rate in these patients. Expand
Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased Mortality
TLDR
In patients with AF and HF, digoxin use is not associated with an increased risk of all-cause mortality when used for rate control when used to control ventricular rate. Expand
Digoxin is Associated with Increased Mortality in Patients with Atrial Fibrillation without Concomitant Heart Failure
TLDR
Digoxin use in this study was associated with increased mortality in patients with AF and without concomitant HF and there was no difference in mortality between the treatment groups. Expand
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TLDR
In ED patients with AF, digoxin was more frequently assigned to vulnerable patients with concomitant HF or valvular heart disease, and digoxin use was not related to a significantly increased risk of mortality. Expand
Increased All-Cause Mortality Associated With Digoxin Therapy in Patients With Atrial Fibrillation
TLDR
It is demonstrated that digoxin therapy was associated with a significant increase in all-cause mortality in AF patients, especially in those without HF, and should be avoided as a first-line agent for heart rate control inAF patients. Expand
Increased mortality associated with digoxin in contemporary patients with atrial fibrillation: findings from the TREAT-AF study.
TLDR
Digoxin was associated with increased risk of death in patients with newly diagnosed AF, independent of drug adherence, kidney function, cardiovascular comorbidities, and concomitant therapies, and these findings challenge current cardiovascular society recommendations on use of digoxin in AF. Expand
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References

SHOWING 1-10 OF 44 REFERENCES
Relationships Between Sinus Rhythm, Treatment, and Survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study
TLDR
An “on-treatment” analysis of the relationship of survival to cardiac rhythm and treatment as they changed over time suggests that any beneficial antiarrhythmic effects of AADs are offset by their adverse effects. Expand
A comparison of rate control and rhythm control in patients with atrial fibrillation.
TLDR
Management of atrial fibrillation with the rhythm-control strategy offers no survival advantage over the rate- control strategy, and there are potential advantages, such as a lower risk of adverse drug effects, with the rate -control strategy. Expand
The effect of digoxin on mortality and morbidity in patients with heart failure.
TLDR
Digoxin did not reduce overall mortality, but it reduced the rate of hospitalization both overall and for worsening heart failure, which defines more precisely the role of digoxin in the management of chronic heart failure. Expand
Association of serum digoxin concentration and outcomes in patients with heart failure.
TLDR
It is demonstrated that higher SDCs were associated with increased mortality and suggested that the effectiveness of digoxin therapy in men with heart failure and a left ventricular ejection fraction of 45% or less may be optimized in the SDC range of 0.5 to 0.8 ng/mL. Expand
New insights into the mechanisms and management of atrial fibrillation.
  • P. Khairy, S. Nattel
  • Medicine
  • CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
  • 2002
TLDR
Key features of recently published clinical guidelines, including a unified classification scheme for AF and issues relating to rate control and maintenance of sinus rhythm, are considered and recent insights into the basic mechanisms underlying AF are discussed. Expand
Intravenous digoxin in acute atrial fibrillation. Results of a randomized, placebo-controlled multicentre trial in 239 patients. The Digitalis in Acute Atrial Fibrillation (DAAF) Trial Group.
  • Medicine
  • European heart journal
  • 1997
TLDR
Acute intravenous treatment with digoxin does not increase the rate of conversion to sinus rhythm, but has a fast acting and clinically significant effect on heart rate and should remain an alternative in haemodynamically stable patients. Expand
Conversion of atrial fibrillation to sinus rhythm and rate control by digoxin in comparison to placebo.
TLDR
Intravenous digoxin offers no substantial advantages over placebo in recent onset atrial fibrillation with respect to conversion, and provides weak rate control. Expand
Digoxin for converting recent-onset atrial fibrillation to sinus rhythm. A randomized, double-blinded trial.
TLDR
Digitalization was not shown to affect the likelihood of reversion to sinus rhythm, and thus cannot be recommended for this purpose in patients with atrial fibrillation. Expand
To what extent do congestive heart failure patients in sinus rhythm benefit from digoxin therapy? A systematic overview and meta-analysis.
TLDR
Data from seven trials of high methodologic quality suggest that, on average, one out of nine patients with CHF and sinus rhythm derive a clinically important benefit from digoxin. Expand
Early statin treatment following acute myocardial infarction and 1-year survival.
TLDR
Early initiation of statin treatment in patients with AMI is associated with reduced 1-year mortality, and the importance of implementing the results of randomized statin trials in unselected AMI patients is emphasized. Expand
...
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