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Digoxin mortality

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https://www.readbyqxmd.com/read/28750542/clinical-presentation-predictors-and-outcomes-among-mineralocorticoid-receptor-antagonist-mra-eligible-acute-heart-failure-patients-in-the-heart-function-assessment-registry-trial-in-saudi-arabia-hearts
#1
Mostafa Q AlShamiri, Khalid F AlHabib, Waleed AlHabeeb, Ismail R Raslan, Anhar Ullah, Abdelfatah A Elasfar, Fayez Alshaer, Hanan Albackr, Layth Mimish, Ali Almasood, Saleh AlGhamdi, Abdullah Ghabashi
Mineralocorticoid receptor antagonist (MRA) therapy is indicated after myocardial infarction in patients with acute heart failure (AHF) with an ejection fraction ≤40% and lacking contraindications. We analyzed clinical presentations, predictors, and outcomes of MRA-eligible patients within a prospective registry of patients with AHF from 18 hospitals in Saudi Arabia, from 2009 to 2010. For this subgroup, mortality rates were followed until 2013, and the clinical characteristics, management, predictors, and outcomes were compared between MRA-treated and non-MRA-treated patients...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28729311/a-review-of-rate-control-in-atrial-fibrillation-and-the-rationale-and-protocol-for-the-rate-af-trial
#2
Dipak Kotecha, Melanie Calvert, Jonathan J Deeks, Michael Griffith, Paulus Kirchhof, Gregory Yh Lip, Samir Mehta, Gemma Slinn, Mary Stanbury, Richard P Steeds, Jonathan N Townend
BACKGROUND AND OBJECTIVE: Atrial fibrillation (AF) is common and causes impaired quality of life, an increased risk of stroke and death as well as frequent hospital admissions. The majority of patients with AF require control of heart rate. In this article , we summarise the limited evidence from clinical trials that guides prescription, and present the rationale and protocol for a new randomised trial. As rate control has not yet been shown to reduce mortality, there is a clear need to compare the impact of therapy on quality of life, cardiac function and exercise capacity...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28720014/the-impact-of-intrauterine-treatment-on-fetal-tachycardia-a-nationwide-survey-in-japan
#3
Keiko Ueda, Yasuki Maeno, Takekazu Miyoshi, Noboru Inamura, Motoyoshi Kawataki, Mio Taketazu, Masaki Nii, Akiko Hagiwara, Hitoshi Horigome, Makio Shozu, Wataru Shimizu, Satoshi Yasukochi, Hitoshi Yoda, Isao Shiraishi, Heima Sakaguchi, Shinji Katsuragi, Haruhiko Sago, Tomoaki Ikeda
OBJECTIVES: To investigate the clinical course of fetal tachycardia and analyze the impact of intrauterine treatment on the postnatal treatment and patient outcomes. STUDY DESIGN: This was a retrospective review of cases of fetal tachycardia that occurred from 2004 to 2006. Data were collected from questionnaires that were sent to all 750 secondary or tertiary perinatal care centers in Japan. RESULTS: Eighty-two cases (14 with fetal hydrops) were analyzed (supraventricular tachycardia [SVT], n = 52; atrial flutter [AFL], n = 23; and ventricular tachycardia, n = 7)...
July 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28692216/-digoxin-and-atrial-fibrillation-in-2016
#4
Sarah Théone, Sebastian Carballo, David Carballo, Christophe Marti
Various properties of digoxin have been exploited for decades, amongst which are its positive inotropy used in the treatment of heart failure, and its vagotonic effect used to slow ventricular response to atrial fibrillation. Pharmacologic properties of digoxin are however characterised by a narrow therapeutic interval, and recent observational studies suggest a potential association with increased mortality in patients with atrial fibrillation. As a result and because of available alternative therapeutic strategies, current guidelines do not recommend digoxin as first line treatment of atrial fibrillation...
October 19, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28666993/digoxin-use-and-subsequent-clinical-outcomes-in-patients-with-atrial-fibrillation-with-or-without-heart-failure-in-the-engage-af-timi-48-trial
#5
Alon Eisen, Christian T Ruff, Eugene Braunwald, Rose A Hamershock, Basil S Lewis, Christian Hassager, Tze-Fan Chao, Jean Yves Le Heuzey, Michele Mercuri, Howard Rutman, Elliott M Antman, Robert P Giugliano
BACKGROUND: Digoxin is widely used in patients with atrial fibrillation despite the lack of randomized controlled trials. Observational studies report conflicting results regarding its association with mortality, perhaps because of residual confounding by the presence of heart failure (HF). METHODS AND RESULTS: In the ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) trial, clinical outcomes of patients with atrial fibrillation with and without HF were examined by baseline digoxin use during a median follow-up of 2...
June 30, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28644688/intraosseous-administration-of-antidotes-a-systematic-review
#6
Audrée Elliott, Pierre-André Dubé, Amélie Cossette-Côté, Laura Patakfalvi, Eric Villeneuve, Martin Morris, Sophie Gosselin
CONTEXT: Intraosseous (IO) access is an established route of administration in resuscitation situations. Patients with serious poisoning presenting to the emergency department may require urgent antidote therapy. However, intravenous (IV) access is not always readily available. OBJECTIVE: This study reviews the current evidence for IO administration of antidotes that could be used in poisoning. The primary outcome was mortality as a surrogate of efficacy. Secondary outcomes included hemodynamic variables, electrocardiographic variables, neurological status, pharmacokinetics outcomes, and adverse effects as defined by each article...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28591151/cardiac-glycosides-use-and-the-risk-and-mortality-of-cancer-systematic-review-and-meta-analysis-of-observational-studies
#7
REVIEW
Mohamed Hosny Osman, Eman Farrag, Mai Selim, Mohamed Samy Osman, Arwa Hasanine, Azza Selim
BACKGROUND: Cardiac glycosides (CGs) including digitalis, digoxin and digitoxin are used in the treatment of congestive heart failure and atrial fibrillation. Pre-clinical studies have investigated the anti-neoplastic properties of CGs since 1960s. Epidemiological studies concerning the association between CGs use and cancer risk yielded inconsistent results. We have performed a systematic review and meta-analysis to summarize the effects of CGs on cancer risk and mortality. METHODS: PubMed, Scopus, Cochrane library, Medline and Web of Knowledge were searched for identifying relevant studies...
2017: PloS One
https://www.readbyqxmd.com/read/28553663/does-the-implantable-cardioverter-defibrillator-benefit-vary-with-the-estimated-proportional-risk-of-sudden-death-in-heart-failure-patients
#8
Wayne C Levy, Yanhong Li, Shelby D Reed, Michael R Zile, Ramin Shadman, Todd Dardas, David J Whellan, Kevin A Schulman, Stephen J Ellis, Matthew Neilson, Christopher M O'Connor
BACKGROUND: Prediction of which heart failure patients are most likely to die of sudden death vs. non-sudden death is an important factor in determining who will benefit the most from an ICD. OBJECTIVE: We developed the Seattle Proportional Risk Model (SPRM) to estimate the proportion of total mortality due to sudden death. We prospectively validated the model in HF-ACTION and tested whether the ICD benefit varied with the SPRM. METHODS: Among 2331 patients enrolled, 1947 patients were retained for analysis over a median follow-up of 2...
March 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28551087/predictors-of-digoxin-use-and-risk-of-mortality-in-ed-patients-with-atrial-fibrillation-results-from-the-chinese-af-registry
#9
Shuang Wu, Yan-Min Yang, Jun Zhu, Jia-Meng Ren, Juan Wang, Han Zhang, Xing-Hui Shao
OBJECTIVES: The aim of this study was to evaluate factors of digoxin use and its relation to mortality in ED patients with atrial fibrillation (AF). METHODS: The Chinese AF registry enrolled 2016 AF patients from 20 representative EDs, and the period of study was one year. Predictors of digoxin use and its relation to mortality were assessed by logistic and Cox regression analyses. RESULTS: Digoxin was assigned in 609 patients (30.6%), and younger age, lower body mass index values, and existence of permanent AF, heart failure (HF), chronic obstructive pulmonary disease, and valvular heart disease were identified to be factors associated with digoxin use...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28520719/sex-differences-in-management-and-outcomes-of-patients-with-atrial-fibrillation-in-the-middle-east-gulf-survey-of-atrial-fibrillation-events-gulf-safe
#10
Abdulla Shehab, Mohammad Zubaid, Akshaya Srikanth Bhagavathula, Wafa A Rashed, Alawi A Alsheikh-Ali, Wal AlMahmeed, Kadhim Sulaiman, Ibrahim Al-Zakwani, Ahmed AlQudaimi, Nidal Asaad, Haitham Amin
Differences in the management of atrial fibrillation (AF) between men and women were investigated by using Gulf SAFE data in the Middle East. The study included 2,043 patients presenting with AF to emergency room (ER) were prospectively enrolled and followed for one-year. Women were older, have higher body mass index (BMI), comorbidities, and health complications than men. With regard to management of AF, cardioversion was recommended more often for men (16.7% vs. 9.3%), and underwent electrical cardioversion (2...
2017: PloS One
https://www.readbyqxmd.com/read/28501416/digoxin-and-30-day-all-cause-readmission-in-long-term-care-residents-hospitalized-for-heart-failure
#11
Helen M Sheriff, Manik R Thogaripally, Gurusher Panjrath, Cherinne Arundel, Qing Zeng, Gregg C Fonarow, Javed Butler, Ross D Fletcher, Charity Morgan, Marc R Blackman, Prakash Deedwania, Thomas E Love, Wilbert S Aronow, Stefan D Anker, Richard M Allman, Ali Ahmed
BACKGROUND: Digoxin use has been shown to be associated with a lower risk of 30-day all-cause hospital readmissions in older patients with heart failure (HF). In the current study, we examined this association among long-term care (LTC) residents hospitalized for HF. METHODS: Of the 8049 Medicare beneficiaries discharged alive after hospitalization for HF from 106 Alabama hospitals, 545 (7%) were LTC residents, of which 227 (42%) received discharge prescriptions for digoxin...
May 11, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28500174/effect-of-digoxin-use-among-medicaid-enrollees-with-atrial-fibrillation
#12
COMPARATIVE STUDY
Demilade Adedinsewo, Junjun Xu, Pradyumna Agasthi, Adesoji Oderinde, Oluwatoyosi Adekeye, Rajesh Sachdeva, George Rust, Anekwe Onwuanyi
BACKGROUND: Recently published analysis of contemporary atrial fibrillation (AF) cohorts showed an association between digoxin and increased mortality and hospitalizations; however, other studies have demonstrated conflicting results. Many AF cohort studies did not or were unable to examine racial differences. Our goal was to examine risk factors for hospitalizations and mortality with digoxin use in a diverse real-world AF patient population and evaluate racial differences. METHODS AND RESULTS: We performed a retrospective cohort analysis of claims data for Medicaid beneficiaries, aged 18 to 64 years, with incident diagnosis of AF in 2008 with follow-up until December 31, 2009...
May 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28493895/the-cardiac-glycoside-ouabain-activates-nlrp3-inflammasomes-and-promotes-cardiac-inflammation-and-dysfunction
#13
Motoi Kobayashi, Fumitake Usui-Kawanishi, Tadayoshi Karasawa, Hiroaki Kimura, Sachiko Watanabe, Nathan Mise, Fujio Kayama, Tadashi Kasahara, Naoyuki Hasebe, Masafumi Takahashi
Cardiac glycosides such as digoxin are Na+/K+-ATPase inhibitors that are widely used for the treatment of chronic heart failure and cardiac arrhythmias; however, recent epidemiological studies have suggested a relationship between digoxin treatment and increased mortality. We previously showed that nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasomes, which regulate caspase-1-dependent interleukin (IL)-1β release, mediate the sterile cardiovascular inflammation...
2017: PloS One
https://www.readbyqxmd.com/read/28422144/risk-and-prediction-of-sudden-cardiac-death-and-ventricular-arrhythmias-for-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#14
Tze-Fan Chao, Chia-Jen Liu, Ta-Chuan Tuan, Su-Jung Chen, Tzeng-Ji Chen, Gregory Y H Lip, Shih-Ann Chen
Sudden cardiac death (SCD) is the most devastating manifestation of ventricular arrhythmias (VAs), and is the leading cause of mortality among atrial fibrillation (AF) patients. The goal of the present study was to investigate the incidence of SCD/VAs amongst patients with and without AF. We also aimed to identify important risk factors of SCD/VAs among AF patients. Using the "National Health Insurance Research Database" in Taiwan, a total of 352,656 AF and 352,656 non-AF patients without antecedent SCD/VAs were identified...
April 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28398365/-digitalis-a-drug-to-be-scrapped
#15
REVIEW
Franco Cosmi, Barbara Tarquini, Beatrice Mariottoni, Deborah Cosmi
We performed a comprehensive review of the scientific literature on the use of digoxin in heart failure and atrial fibrillation. In congestive heart failure (CHF) there is only one randomized trial with a statistical sample sufficiently large. In this trial (DIG trial), which enrolled patients with systolic left ventricular dysfunction in sinus rhythm, digoxin had a neutral action on mortality and modestly reduced the overall need of hospitalization. The study was conducted in the pre-beta-blocker era and, therefore, it has a doubtful application to the current clinical context...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28371247/ivabradine-current-and-future-treatment-of-heart-failure
#16
REVIEW
Lene Thorup, Ulf Simonsen, Daniela Grimm, Elise R Hedegaard
In heart failure (HF), the heart cannot pump blood efficiently and is therefore unable to meet the body's demands of oxygen, and/or there is increased end-diastolic pressure. Current treatments for HF with reduced ejection fraction (HFrEF) include angiotensin-converting enzyme (ACE) inhibitors, angiotension receptor type 1 (AT1 ) antagonists, β-adrenoceptor antagonists, aldosterone receptor antagonists, diuretics, digoxin and a combination drug with AT1 receptor antagonist and neprilysin inhibitor. In HF, the risk of readmission for hospital and mortality is markedly higher with a heart rate (HR) above 70 bpm...
April 2, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28363353/propranolol-versus-digoxin-in-the-neonate-for-supraventricular-tachycardia-from-the-pediatric-health-information-system
#17
RANDOMIZED CONTROLLED TRIAL
Elijah H Bolin, Sean M Lang, Xinyu Tang, R Thomas Collins
Conflicting data exist for the appropriate management of a neonate with supraventricular tachycardia (SVT). We sought to assess postnatal prescribing trends for neonates with SVT and to evaluate if there were therapy-specific mortality and resource utilization benefits. Nationally distributed data from 44 pediatric hospitals in the 2004 to 2015 Pediatric Health Information System database were used to identify patients admitted at ≤2 days of age with structurally normal hearts and treated with an antiarrhythmic medication...
May 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28353316/quality-of-care-of-hospitalised-patients-with-heart-failure-in-poland-in-2013-results-of-the-second-nationwide-survey
#18
Małgorzata Fedyk-Łukasik, Barbara Wizner, Grzegorz Opolski, Tomasz Zdrojewski, Marcin Czech, Jacek S Dubiel, Michał Marchel, Tomasz Rywik, Jerzy Korewicki, Tomasz Grodzicki
BACKGROUND: Optimal management of heart failure (HF) patients is crucial to reduce both mortality and the number of hospital admissions, at the same time improving patients' quality of life. AIM: The aim of the study was to assess the quality of care of hospitalised patients with HF in Poland in 2013 and compare it with the results of a similar survey performed in 2005. METHODS: The presented study was conducted from April to November 2013 in a sample of 260 hospital wards in Poland, recruited by stratified proportional sampling...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28340150/severe-conduction-defects-requiring-permanent-pacemaker-implantation-in-patients-with-a-new-onset-left-bundle-branch-block-after-transcatheter-aortic-valve-implantation
#19
V J Nijenhuis, V F Van Dijk, S M Chaldoupi, J C Balt, J M Ten Berg
Aims: Transcatheter aortic valve implantation (TAVI) is frequently associated with cardiac conduction defects (CCD) requiring permanent pacemaker implantation (PPI). Although new-onset left bundle branch block (LBBB) is often seen, the rate of progression to severe CCD is unclear. We aimed to find clinical and electrocardiographic (ECG) parameters associated with severe CCD requiring PPI in patients with a new-onset LBBB after TAVI and assess its effect on clinical outcome. Methods and results: All consecutive patients undergoing TAVI who developed a new-onset LBBB were retrospectively analysed...
June 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28228305/clinical-presentation-management-and-outcomes-in-the-indian-heart-rhythm-society-atrial-fibrillation-ihrs-af-registry
#20
A Vora, A Kapoor, M Nair, Y Lokhandwala, C Narsimhan, A G Ravikishore, S K Dwivedi, N Namboodiri, R Hygriv, A Saxena, A Nabar, S Garg, N Bardoloi, R Yadav, A Nambiar, U Pandurangi, D Jhala, A Naik, Nagmallesh, S Rajagopal, R Selvaraj, V Arora, A Thachil, J Thomas, G Panicker
AIM: A national atrial fibrillation (AF) registry was conducted under the aegis of the Indian Heart Rhythm Society (IHRS), to capture epidemiological data-type of AF, clinical presentation and comorbidities, current treatment practices, and 1-year follow-up outcomes. METHODS: A total of 1537 patients were enrolled from 24 sites in India in the IHRS-AF registry from July 2011 to August 2012. Their baseline characteristics and follow-up data were recorded in case report forms and subsequently analyzed...
January 2017: Indian Heart Journal
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