Tags

Type your tag names separated by a space and hit enter

Digoxin use and heart failure outcomes: results from the Valsartan Heart Failure Trial (Val-HeFT).
Congest Heart Fail. 2010 Sep-Oct; 16(5):191-5.CH

Abstract

Several retrospective studies have raised concerns regarding digoxin therapy in select subgroups of heart failure patients. To assess the impact of digoxin therapy on outcomes in the current era of heart failure therapy, the authors analyzed data representing 5010 patients enrolled in the Valsartan Heart Failure Trial (Val-HeFT) to examine the relationship of baseline digoxin use and all-cause mortality, first morbid event, and heart failure hospitalizations. At baseline, 3374 patients (67%) were receiving digoxin therapy and 1636 (33%) were not. Patients receiving digoxin had features of worse heart failure with higher New York Heart Association class and lower blood pressure, ejection fraction, and β-blocker use (32.1% vs 40.8%). Digoxin use was associated with worse mortality (21.1 vs 15.0%, P<.001), first morbid event (34.6 vs 21.7, P<.001), and HF hospitalization rate (19.1 vs 10.1%, P<.001). After adjustment for baseline group differences including medical therapy and baseline rhythm, patients receiving digoxin remained at a higher risk for all-cause mortality (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.05-1.57), first morbid event (HR, 1.35; 95% CI, 1.15-1.59), and heart failure hospitalization (HR, 1.41; 95% CI, 1.12-1.78). These results remained materially unchanged with propensity matched analysis. No benefit with digoxin use was observed in this study, underscoring the need to reassess the role of digoxin in the contemporary management of heart failure.

Authors+Show Affiliations

Emory University, Atlanta, GA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

20887614

Citation

Butler, Javed, et al. "Digoxin Use and Heart Failure Outcomes: Results From the Valsartan Heart Failure Trial (Val-HeFT)." Congestive Heart Failure (Greenwich, Conn.), vol. 16, no. 5, 2010, pp. 191-5.
Butler J, Anand IS, Kuskowski MA, et al. Digoxin use and heart failure outcomes: results from the Valsartan Heart Failure Trial (Val-HeFT). Congest Heart Fail. 2010;16(5):191-5.
Butler, J., Anand, I. S., Kuskowski, M. A., Rector, T., Carson, P., & Cohn, J. N. (2010). Digoxin use and heart failure outcomes: results from the Valsartan Heart Failure Trial (Val-HeFT). Congestive Heart Failure (Greenwich, Conn.), 16(5), 191-5. https://doi.org/10.1111/j.1751-7133.2010.00161.x
Butler J, et al. Digoxin Use and Heart Failure Outcomes: Results From the Valsartan Heart Failure Trial (Val-HeFT). Congest Heart Fail. 2010 Sep-Oct;16(5):191-5. PubMed PMID: 20887614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Digoxin use and heart failure outcomes: results from the Valsartan Heart Failure Trial (Val-HeFT). AU - Butler,Javed, AU - Anand,Inder S, AU - Kuskowski,Michael A, AU - Rector,Thomas, AU - Carson,Peter, AU - Cohn,Jay N, AU - ,, PY - 2010/10/5/entrez PY - 2010/10/5/pubmed PY - 2011/4/28/medline SP - 191 EP - 5 JF - Congestive heart failure (Greenwich, Conn.) JO - Congest Heart Fail VL - 16 IS - 5 N2 - Several retrospective studies have raised concerns regarding digoxin therapy in select subgroups of heart failure patients. To assess the impact of digoxin therapy on outcomes in the current era of heart failure therapy, the authors analyzed data representing 5010 patients enrolled in the Valsartan Heart Failure Trial (Val-HeFT) to examine the relationship of baseline digoxin use and all-cause mortality, first morbid event, and heart failure hospitalizations. At baseline, 3374 patients (67%) were receiving digoxin therapy and 1636 (33%) were not. Patients receiving digoxin had features of worse heart failure with higher New York Heart Association class and lower blood pressure, ejection fraction, and β-blocker use (32.1% vs 40.8%). Digoxin use was associated with worse mortality (21.1 vs 15.0%, P<.001), first morbid event (34.6 vs 21.7, P<.001), and HF hospitalization rate (19.1 vs 10.1%, P<.001). After adjustment for baseline group differences including medical therapy and baseline rhythm, patients receiving digoxin remained at a higher risk for all-cause mortality (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.05-1.57), first morbid event (HR, 1.35; 95% CI, 1.15-1.59), and heart failure hospitalization (HR, 1.41; 95% CI, 1.12-1.78). These results remained materially unchanged with propensity matched analysis. No benefit with digoxin use was observed in this study, underscoring the need to reassess the role of digoxin in the contemporary management of heart failure. SN - 1751-7133 UR - https://www.unboundmedicine.com/medline/citation/20887614/Digoxin_use_and_heart_failure_outcomes:_results_from_the_Valsartan_Heart_Failure_Trial__Val_HeFT__ L2 - https://doi.org/10.1111/j.1751-7133.2010.00161.x DB - PRIME DP - Unbound Medicine ER -