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Digoxin mortality

Renato D Lopes, Roberto Rordorf, Gaetano M De Ferrari, Sergio Leonardi, Laine Thomas, Daniel M Wojdyla, Peter Ridefelt, John H Lawrence, Raffaele De Caterina, Dragos Vinereanu, Michael Hanna, Greg Flaker, Sana M Al-Khatib, Stefan H Hohnloser, John H Alexander, Christopher B Granger, Lars Wallentin
BACKGROUND: Digoxin is widely used in patients with atrial fibrillation (AF). OBJECTIVES: The goal of this paper was to explore whether digoxin use was independently associated with increased mortality in patients with AF and if the association was modified by heart failure and/or serum digoxin concentration. METHODS: The association between digoxin use and mortality was assessed in 17,897 patients by using a propensity score-adjusted analysis and in new digoxin users during the trial versus propensity score-matched control participants...
March 13, 2018: Journal of the American College of Cardiology
Naqash J Sethi, Emil E Nielsen, Sanam Safi, Joshua Feinberg, Christian Gluud, Janus C Jakobsen
BACKGROUND: During recent years, systematic reviews of observational studies have compared digoxin to no digoxin in patients with atrial fibrillation or atrial flutter, and the results of these reviews suggested that digoxin seems to increase the risk of all-cause mortality regardless of concomitant heart failure. Our objective was to assess the benefits and harms of digoxin for atrial fibrillation and atrial flutter based on randomized clinical trials. METHODS: We searched CENTRAL, MEDLINE, Embase, LILACS, SCI-Expanded, BIOSIS for eligible trials comparing digoxin versus placebo, no intervention, or other medical interventions in patients with atrial fibrillation or atrial flutter in October 2016...
2018: PloS One
Adam Oesterle, Benjamin Weber, Roderick Tung, Niteesh K Choudhry, Jagmeet P Singh, Gaurav A Upadhyay
BACKGROUND: Although post-operative atrial fibrillation is common after non-cardiac surgery, there is a paucity of data regarding prophylaxis. We sought to determine if pharmacologic prophylaxis reduces the incidence of post-operative atrial fibrillation after non-cardiac surgery. METHODS: We performed an electronic search of Ovid MEDLINE, the Cochrane central register of controlled trials database, and SCOPUS from inception to 9/7/2016 and included prospective randomized studies in which patients in sinus rhythm underwent non-cardiac surgery and examined the incidence of post-operative atrial fibrillation as well as secondary safety outcomes...
February 21, 2018: American Journal of Medicine
P Z Szymanski, M Badri, B M Mayosi
BACKGROUND: There is limited information on acute heart failure (AHF) and its treatment in sub-Saharan Africa. OBJECTIVE: To describe the clinical characteristics and causes of heart failure (HF), adherence to HF treatment guidelines, and mortality of patients with AHF presenting to Groote Schuur Hospital (GSH), Cape Town, South Africa. METHODS: This sub-study of The Sub-Saharan Africa Survey of Heart Failure (THESUS-HF) was a prospective and observational survey that focused on the enrolment and follow-up of additional patients with AHF presenting to GSH and entered into the existing registry after publication of the primary THESUS-HF article in 2012...
February 1, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Richard H Tran, Ahmed Aldemerdash, Patricia Chang, Carla A Sueta, Brystana Kaufman, Josephine Asafu-Adjei, Orly Vardeny, Eliza Daubert, Khalid A Alburikan, Anna M Kucharska-Newton, Sally C Stearns, Jo E Rodgers
BACKGROUND: Modification of guideline-directed medical therapy (GDMT) in hospitalized patients with heart failure (HF) has not been extensively evaluated. METHODS: The community surveillance arm of the Atherosclerosis Risk in Communities Study identified 6959 HF hospitalizations from 2005 to 2011. Predictors of GDMT modification and survival were assessed using multivariable logistic regression and Cox proportional hazards models. RESULTS: For 5091 hospitalizations, patient mean age was 75 years old, 53% were female, 69% were Caucasian, and 81% had acute decompensated HF (ADHF)...
February 9, 2018: Pharmacotherapy
Alexander W Labossiere, Dennis F Thompson
OBJECTIVES: Yew plant materials contain highly toxic taxine alkaloids. Serious ingestions can result in life-threatening toxicity. The purpose of this article is to summarize the literature on the treatment of acute yew poisoning. DATA SOURCES: PubMed (January 1946 to November 2017) was searched using the search terms "taxus/po". EMBASE (1980 to November 2017) was searched using the search terms "taxus/to" and "" Web of Science (1945 to November 2017) was searched using the text words taxus, taxine, and yew...
January 1, 2018: Annals of Pharmacotherapy
Marise Gauci, Francesca Wirth, Liberato Camilleri, Lilian M Azzopardi, Anthony Serracino-Inglott
Background: Atrial fibrillation (AF) is highly prevalent in older persons and is associated with considerable morbidity and mortality. Assessing appropriateness of drug therapy in AF may be facilitated by application of medication assessment tools (MATs). Objective: To develop, psychometrically evaluate and apply an innovative MAT for the long-term management of AF with particular relevance to older persons. Methods: Key recommendations from clinical practice guidelines for the long-term management of AF were selected and review criteria defining appropriate drug therapy were constructed as a 'qualifying statement' followed by a 'standard'...
October 2017: Pharmacy Practice
Přemysl Mladěnka, Lenka Applová, Jiří Patočka, Vera Marisa Costa, Fernando Remiao, Jana Pourová, Aleš Mladěnka, Jana Karlíčková, Luděk Jahodář, Marie Vopršalová, Kurt J Varner, Martin Štěrba
Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases...
January 5, 2018: Medicinal Research Reviews
Estela de O Lima, Tatiane M Guerreiro, Carlos Fernando O R Melo, Diogo N de Oliveira, Daisy Machado, Marcelo Lancelloti, Rodrigo R Catharino
Recently, microcephaly cases have increased in Americas and have been matter of concern due to Zika virus (ZIKV) recent outbreak. Previous studies have shown that ZIKV-infected progenitor neuronal cells present morphological abnormalities and increased rates of cell death, which may be indicators of microcephaly causes. As recent studies indicate Zika virus' tropism for brain cells, how would a glioblastoma (GBM) lineage behave under ZIKV infection, considering GBM the most common and malignant brain tumor in adults, presenting extreme chemoresistance and high morbidity and mortality rates? The current trend of using genetically engineered oncolytic pathogens as a safe way to eliminate tumors is under development, with trials already in course...
December 28, 2017: Journal of Mass Spectrometry: JMS
Jenica N Upshaw, David van Klaveren, Marvin A Konstam, David M Kent
BACKGROUND: Digoxin has been shown to reduce heart failure hospitalizations with a neutral effect on mortality. It is unknown whether there is heterogeneity of treatment effect for digitalis therapy according to predicted risk of heart failure hospitalization. METHODS AND RESULTS: We conducted a post hoc analysis of the Digitalis Investigator Group (DIG) studies, randomized controlled trials of digoxin vs placebo in participants with heart failure and left ventricular ejection fraction ≤45% (main DIG study, n = 6800) or >45% (ancillary DIG study, n = 988)...
December 25, 2017: American Journal of Medicine
Kamala Kh Zahidova
BACKGROUND: Anemia aggravates the disease course and the survival rate of chronic heart failure (CHF) patients. The purpose of the study was to investigate the level of erythropoietin (EPO) in CHF patients with anemic syndrome, with the aim to more accurately assess the severity of the disease and its treatment, depending on the anemia degree. METHODS: Patients with ischemic CHF of I-IV functional class (FC) with and without anemia were examined (total number of patients=208, patients with anemia=174)...
January 26, 2018: Journal of Basic and Clinical Physiology and Pharmacology
Deirdre Cronin-Fenton, Timothy L Lash, Thomas P Ahern, Per Damkier, Peer Christiansen, Bent Ejlertsen, Henrik T Sørensen
BACKGROUND: Myriad reports suggest that frequently used prescription drugs alter the viability of breast cancer cells in pre-clinical studies. Routine use of these drugs, therefore, may impact breast cancer prognosis, and could have important implications for public health. METHODS: The Danish Breast Cancer Group (DBCG) clinical database provides high-quality prospectively collected data on breast cancer diagnosis, treatment, and routine follow-up for breast cancer recurrence...
January 2018: Acta Oncologica
Jayaprakash Shenthar, Jayasheelan Mambally Rachaiah, Vivek Pillai, Siva Sankara Chakali, Vidhyakar Balasubramanian, Manjunath Chollenhalli Nanjappa
AIM: To define the incidence, presentation, and outcomes of drug-induced Torsades de Pointes (TdP) with intravenous (IV) amiodarone. METHODS: From January 2014 to August 2016 a total of 268 patients received IV amiodarone, 142 for ventricular tachycardia, 104 for atrial flutter/fibrillation, and 22 for incessant atrial tachycardia. A uniform dosing of amiodarone to yield 1gm/day was used in all patients. RESULTS: Four of the 268 patients (M:F 1:3) with mean age of 51...
November 2017: Indian Heart Journal
Hee Tae Yu, Pil-Sung Yang, Hancheol Lee, Seng Chan You, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
BACKGROUND: Rate control is now a front-line therapy in the management of atrial fibrillation (AF). However, the survival benefits of different rate-control medications remain controversial, so we assessed the efficacy of rate-control medications in AF patients with concomitant heart failure (HF).Methods and Results:From January 2002 to December 2008, a total of 7,034 AF patients with a single type of rate-control drug or without rate-control treatment were enrolled from the Korea National Health Insurance Service database...
November 14, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
Paul Min Thein, Kyle White, Khyati Banker, Carole Lunny, Sam Mirzaee, Arthur Nasis
BACKGROUND: Current epidemiological data suggests that postoperative atrial fibrillation or atrial flutter (POAF) causes significant morbidity and mortality after cardiac surgery. The literature for prophylactic management of POAF is limited, resulting in the lack of clear guidelines on management recommendations. AIM: To examine the efficacy of prophylactic rate control agents in reducing the incidence of new-onset POAF in patients undergoing elective cardiac surgery...
October 19, 2017: Heart, Lung & Circulation
Rasmus Rivinius, Matthias Helmschrott, Arjang Ruhparwar, Ann-Kathrin Rahm, Fabrice F Darche, Dierk Thomas, Tom Bruckner, Philipp Ehlermann, Hugo A Katus, Andreas O Doesch
OBJECTIVES: Digitalis therapy (digoxin or digitoxin) in patients with heart failure is subject to an ongoing debate. Recent data suggest an increased mortality in patients receiving digitalis. This study investigated the effects of chronic digitalis therapy prior to heart transplantation (HTX) on posttransplant outcomes. PATIENTS AND METHODS: This was a retrospective, observational, single-center study. It comprised 530 adult patients who were heart-transplanted at Heidelberg University Hospital between 1989 and 2012...
2017: Therapeutics and Clinical Risk Management
George S Mina, Madan Acharya, Taylor Shepherd, George Gobrial, Michael Tekeste, Hussam Watti, Ruchi Bhandari, Aditya Saini, Pratap Reddy, Paari Dominic
AIM: Recently, digoxin use has been found to associate with higher mortality. Yet, potential mechanisms by which digoxin use increases mortality remain unclear. Increased arrhythmogenicity from digoxin use is one possibility. Thus, we aimed to evaluate the relation between digoxin and shock events in patients with implantable cardioverter defibrillators (ICDs). METHODS: We performed a retrospective chart review of all patients with ICDs and at least 1 device interrogation at our institution between January 1, 2012, and January 1, 2015...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
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
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
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
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