Safety of digoxin in nonagenarian patients with atrial fibrillation: lessons from the Spanish Multicenter Registry

Pablo Domínguez-Erquicia; Sergio Raposeiras-Roubín; Emad Abu-Assi; María Cespón-Fernández; David Alonso-Rodríguez; Santiago Jesús Camacho-Freire; Naiara Cubelos-Fernández; Álvaro López-Masjuán Ríos; María Melendo-Viu; Andrés Íñiguez-Romo

doi:10.11909/j.issn.1671-5411.2021.10.007

Volume 18 Issue 10

Oct. 2021

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Article Navigation > Journal of Geriatric Cardiology > 2021 > 18(10): 809-815

Please cite this article as: Domínguez-Erquicia P, Raposeiras-Roubín S, Abu-Assi E, Cespón-Fernández M, Alonso-Rodríguez D, Camacho-Freire SJ, Cubelos-Fernández N, Ríos ALM, Melendo-Viu M, Íñiguez-Romo A. Safety of digoxin in nonagenarian patients with atrial fibrillation: lessons from the Spanish Multicenter Registry. J Geriatr Cardiol 2021; 18(10): 809−815. DOI: 10.11909/j.issn.1671-5411.2021.10.007

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Please cite this article as: Domínguez-Erquicia P, Raposeiras-Roubín S, Abu-Assi E, Cespón-Fernández M, Alonso-Rodríguez D, Camacho-Freire SJ, Cubelos-Fernández N, Ríos ALM, Melendo-Viu M, Íñiguez-Romo A. Safety of digoxin in nonagenarian patients with atrial fibrillation: lessons from the Spanish Multicenter Registry. J Geriatr Cardiol 2021; 18(10): 809−815. DOI: 10.11909/j.issn.1671-5411.2021.10.007

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Safety of digoxin in nonagenarian patients with atrial fibrillation: lessons from the Spanish Multicenter Registry

doi: 10.11909/j.issn.1671-5411.2021.10.007

1.
Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain
2.
Health Research Institute Galicia Sur, Vigo, Spain
3.
Department of Cardiology, University Hospital of León, León, Spain
4.
Department of Cardiology, University Hospital Juan Ramón Jiménez, Huelva, Spain

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Corresponding author: raposeiras26@hotmail.com
Available Online: 2021-10-27
Publish Date: 2021-10-28

Abstract

Abstract

BACKGROUND The association between digoxin and mortality is an unclear issue. In older patients with atrial fibrillation (AF), where use of digoxin is frequent, the evidence of its safety is scarce. Our aim is to assess the safety of digoxin in nonagenarian patients with AF. METHODS We evaluated data from 795 nonagenarian patients with non-valvular AF from the Spanish Multicenter Registry. We analyzed the relationship between digoxin and all-cause mortality with the Cox proportional-hazards model. RESULTS Follow-up was 27.7 ± 18.3 months. Mean age was 92.5 ± 3.8 years, and 71% of nonagenarian patients were female. Digoxin was not associated with increased risk of mortality [adjusted hazard ratio (aHR) = 1.16, 95% CI: 0.96−1.41, P = 0.130]. However, we found a significant increase in mortality in the subgroup with estimated glomerular filtration rate (eGFR) < 30 mL/min per 1.73 m² (aHR = 2.01, 95% CI: 1.13−3.57, P = 0.018), but not in the other subgroups of eGFR (30−59 mL/min per 1.73 m² and ≥ 60 mL/min per 1.73 m²). When exploring the risk of mortality according to sex, male subgroup was associated with an increase in mortality (aHR = 1.48, 95% CI: 1.02−2.14, P = 0.041). This was not observed in females subgroup (aHR = 1.03, 95% CI: 0.81−1.29, P = 0.829). Based on the presence or absence of heart failure, we did not find significant differences (aHR = 1.20, 95% CI: 0.87−1.65, P = 0.268 vs. aHR = 1.15, 95% CI: 0.90−1.47, P = 0.273, respectively). CONCLUSIONS In our large registry of nonagenarian patients with AF, we did not find an association between digoxin and mortality in the total sample. However, in the subgroup analyses, we found an increase in mortality with the use of digoxin in men and in patients with an eGFR < 30 mL/min per 1.73 m².

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References(22)

References

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