Digoxin and reduction in mortality and hospitalization in geriatric heart failure: importance of low doses and low serum concentrations.

Digoxin and reduction in mortality and hospitalization in geriatric heart failure: importance of low doses and low serum concentrations. Research Abstract Details 

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Digoxin and reduction in mortality and hospitalization in geriatric heart failure: importance of low doses and low serum concentrations. Abstract Text:

Ali Ahmed,

BACKGROUND: Digoxin reduces hospitalizations due to heart failure (HF) and may also reduce mortality at low serum digoxin concentrations (SDC). Most HF patients are > or = 65 years, yet the effects of digoxin on outcomes in these patients have not been well studied. METHODS: Of the 7788 ambulatory chronic HF patients in normal sinus rhythm in the Digitalis Investigation Group trial (1991-1995), 5548 (2890 were > or = 65 years) were alive at 1 month and were either receiving placebo or had data on SDC. Of these patients, 982 had low (0.5-0.9 ng/mL) and 705 had high (> or = 1 ng/mL) SDC. RESULTS: Among patients > or = 65 years, compared with 38% placebo patients, 34% low SDC patients died during 39 months of median follow-up (adjusted hazard ratio [AHR] = 0.81; 95% confidence interval [CI] = 0.68-0.96; p =.017). All-cause hospitalizations occurred in 70% of placebo and 68% of low-SDC patients (AHR = 0.86; 95% CI = 0.76-0.98; p =.019). Reduction in hospitalizations for HF occurred in both low and high SDC groups. High SDC was not independently associated with all-cause hospitalization or all-cause mortality. Age, impaired renal function, and pulmonary congestion reduced the odds of low SDC. Low-dose digoxin (< or = 0.125 mg/d) was the strongest independent predictor of low SDC (adjusted odd ratio = 2.37; 95% CI = 1.65-3.39); p <.0001). CONCLUSIONS: Digoxin at low SDC was associated with a reduction in mortality and hospitalization in chronic geriatric HF, and low-dose digoxin was the strongest predictor of low SDC.

Digoxin and reduction in mortality and hospitalization in geriatric heart failure: importance of low doses and low serum concentrations. Publishing Authors By Initials

A Ahmed,

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Digoxin and reduction in mortality and hospitalization in geriatric heart failure: importance of low doses and low serum concentrations. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: The journals of gerontology. Series A, Biological

VOLUME: 62

Page Numbers: 323-9

Journal Abbreviation: J. Gerontol. A Biol. Sci. Med.

ISSN: 1079-5006

DAY: 3

MONTH: Mar

YEAR: 2007

Digoxin and reduction in mortality and hospitalization in geriatric heart failure: importance of low doses and low serum concentrations. Information

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LANGUAGE: eng

NlmUniqueID: 9502837

Digoxin and reduction in mortality and hospitalization in geriatric heart failure: importance of low doses and low serum concentrations. Keywords Mesh Terms:

KEYWORDS: United States

MESH TERMS: epidemiology

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Substance Name: Creatinine

Registry Number: 60-27-5

Grant and Affiliation Information for Digoxin and reduction in mortality and hospitalization in geriatric heart failure: importance of low doses and low serum concentrations.

AFFILIATION: Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham AL 35294-2041, USA. aahmed@uab.edu

Country: United States

AGENCY: United States NHLBI

GRANT: P50 HL077100

ACRONYM: HL

MEDLINETA: J Gerontol A Biol Sci Med Sci

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