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Digoxin and Mortali...
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Lopes, Renato D.Duke Univ, Sch Med, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA.
(author)
Digoxin and Mortality in Patients With Atrial Fibrillation
- Article/chapterEnglish2018
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ELSEVIER SCIENCE INC,2018
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LIBRIS-ID:oai:DiVA.org:uu-350280
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-350280URI
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https://doi.org/10.1016/j.jacc.2017.12.060DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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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. The authors investigated the independent association between serum digoxin concentration and mortality after multivariable adjustment.RESULTS: At baseline, 5,824 (32.5%) patients were receiving digoxin. Baseline digoxin use was not associated with an increased risk of death (adjusted hazard ratio [HR]: 1.09; 95% confidence interval [CI]: 0.96 to 1.23; p = 0.19). However, patients with a serum digoxin concentration $ 1.2 ng/ml had a 56% increased hazard of mortality (adjusted HR: 1.56; 95% CI: 1.20 to 2.04) compared with those not on digoxin. When analyzed as a continuous variable, serum digoxin concentration was associated with a 19% higher adjusted hazard of death for each 0.5-ng/ml increase (p = 0.0010); these results were similar for patients with and without heart failure. Compared with propensity score-matched control participants, the risk of death (adjusted HR: 1.78; 95% CI: 1.37 to 2.31) and sudden death (adjusted HR: 2.14; 95% CI: 1.11 to 4.12) was significantly higher in new digoxin users.CONCLUSIONS: In patients with AF taking digoxin, the risk of death was independently related to serum digoxin concentration and was highest in patients with concentrations $ 1.2 ng/ml. Initiating digoxin was independently associated with higher mortality in patients with AF, regardless of heart failure.
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Rordorf, RobertoFdn IRCCS Policlin San Matteo, Coronary Care Unit, Pavia, Italy.;Fdn IRCCS Policlin San Matteo, Lab Clin & Expt Cardiol, Pavia, Italy.;Univ Pavia, Dept Mol Med, Pavia, Italy.
(author)
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De Ferrari, Gaetano M.Fdn IRCCS Policlin San Matteo, Coronary Care Unit, Pavia, Italy.;Fdn IRCCS Policlin San Matteo, Lab Clin & Expt Cardiol, Pavia, Italy.;Univ Pavia, Dept Mol Med, Pavia, Italy.
(author)
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Leonardi, SergioFdn IRCCS Policlin San Matteo, Coronary Care Unit, Pavia, Italy.;Fdn IRCCS Policlin San Matteo, Lab Clin & Expt Cardiol, Pavia, Italy.;Univ Pavia, Dept Mol Med, Pavia, Italy.
(author)
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Thomas, LaineDuke Univ, Sch Med, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA.
(author)
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Wojdyla, Daniel M.Duke Univ, Sch Med, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA.
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Ridefelt, PeterUppsala universitet,Klinisk kemi(Swepub:uu)peteride
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Lawrence, John H.Bristol Myers Squibb Co, Princeton, NJ USA.
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De Caterina, RaffaeleUniv G dAnnunzio, Inst Cardiol, Chieti, Italy.
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Vinereanu, DragosUniv & Emergency Hosp, Univ Med & Pharm Carol Davila, Bucharest, Romania.
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Hanna, MichaelUniv G dAnnunzio, Inst Cardiol, Chieti, Italy.
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Flaker, GregUniv Missouri, Columbia, MO USA.
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Al-Khatib, Sana M.Duke Univ, Sch Med, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA.
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Hohnloser, Stefan H.Goethe Univ Frankfurt, Frankfurt, Germany.
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Alexander, John H.Duke Univ, Sch Med, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA.
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Granger, Christopher B.Duke Univ, Sch Med, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA.
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Wallentin, Lars,1943-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)larswall
(author)
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Duke Univ, Sch Med, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA.Fdn IRCCS Policlin San Matteo, Coronary Care Unit, Pavia, Italy.;Fdn IRCCS Policlin San Matteo, Lab Clin & Expt Cardiol, Pavia, Italy.;Univ Pavia, Dept Mol Med, Pavia, Italy.
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In:Journal of the American College of Cardiology: ELSEVIER SCIENCE INC71:10, s. 1063-10740735-10971558-3597
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