Effects of Discontinuation of Digoxin Versus Continuation at Low Serum Digoxin Concentrations in Chronic Heart Failure

Ali Ahmed, Giovanni Gambassi, Michael T. Weaver, James B. Young, William H. Wehrmacher, Michael W. Rich

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Discontinuation of digoxin is associated with worsening heart failure (HF) symptoms. However, the long-term effects of discontinuation of digoxin therapy on mortality and morbidity in HF have not been well studied. Of the 7,788 participants in the Digoxin Investigation Group trial, 3,365 received digoxin before randomization. During the trial, digoxin was continued in 1,666 patients and discontinued in 1,699 patients. Using multivariable Cox regression analyses, we first determined the effect of discontinuation of digoxin on mortality and hospitalization during 39.7 months of median follow-up. Of the 1,666 patients continued on digoxin, 457 had low (0.5 to 0.9 ng/ml) and 340 had high (≥1.0 ng/ml) serum digoxin concentrations (SDC) after 1 month of therapy and of the 1,699 patients whose digoxin was discontinued, 1,674 were alive at 1 month. We examined the effects of continuation of digoxin at low or high SDC. Compared with continuation of long-term digoxin therapy, discontinuation of digoxin was associated with a significant increase in all-cause hospitalization (adjusted hazard ratio [AHR] 1.18, 95% confidence interval [CI] 1.09 to 1.28, p

Original languageEnglish (US)
Pages (from-to)280-284
Number of pages5
JournalThe American Journal of Cardiology
Volume100
Issue number2
DOIs
StatePublished - Jul 15 2007
Externally publishedYes

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Digoxin
Heart Failure
Serum
Hospitalization
Mortality
Random Allocation
Therapeutics
Regression Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effects of Discontinuation of Digoxin Versus Continuation at Low Serum Digoxin Concentrations in Chronic Heart Failure. / Ahmed, Ali; Gambassi, Giovanni; Weaver, Michael T.; Young, James B.; Wehrmacher, William H.; Rich, Michael W.

In: The American Journal of Cardiology, Vol. 100, No. 2, 15.07.2007, p. 280-284.

Research output: Contribution to journalArticle

Ahmed, Ali ; Gambassi, Giovanni ; Weaver, Michael T. ; Young, James B. ; Wehrmacher, William H. ; Rich, Michael W. / Effects of Discontinuation of Digoxin Versus Continuation at Low Serum Digoxin Concentrations in Chronic Heart Failure. In: The American Journal of Cardiology. 2007 ; Vol. 100, No. 2. pp. 280-284.
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