Digoxin and Incident A-Fib: New Results on Mortality, Hospitalization Risk

the MPR take:

Previous research has linked use of digoxin to an increased risk of death in patients newly diagnosed with atrial fibrillation (AF), and new findings suggest that it also carries an increased risk of hospitalization in adults with incident AF and no heart failure. A retrospective cohort study of 14,787 age, gender, and high-dimensional propensity score-matched adults with incident AF and no prior heart failure or digoxin use examined data on newly initiated digoxin and risk of death and hospitalization. Over the course of a median of 1.7 years of follow-up, incident digoxin use was independently associated with a 71% higher risk of death (hazard ratio [HR] 1.71, 95% CI: 1.52–1.93) and a 63% higher risk of hospitalization (HR 1.63, 95%CI: 1.56–1.71). Digoxin should be used with caution in the management of AF, the authors conclude, particularly given the other rate control treatment options.

Methods and Results- We performed a retrospective cohort study of 14,787 age, gender and high-dimensional propensity score-matched adults with incident atrial fibrillation and no prior heart failure or digoxin use in the AnTicoagulation and Risk factors In Atrial fibrillation-Cardiovascular Research Network (ATRIA-CVRN) Study within Kaiser Permanente Northern and Southern California.

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