Evidence map›Paper›PMID 24257326›Full record

ArticleThe American journal of medicine2014

Digoxin use and lower 30-day all-cause readmission for Medicare beneficiaries hospitalized for heart failure.

Ali Ahmed, Robert C Bourge, Gregg C Fonarow, Kanan Patel, Charity J Morgan, Jerome L Fleg, Inmaculada B Aban, Thomas E Love, Clyde W Yancy, Prakash Deedwania and 4 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 3 pooled it
5.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. The comeback of digitalis (digitoxin): the DIGIT-HF trial.European heart journal supplements : journal of the European Society of Cardiology · 2026
    Article
  7. Review
  8. Article
  9. Observational
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 5 countries.

Ali AhmedUniversity of Alabama at Birmingham, Birmingham, Ala; Veterans Affairs Medical Center, Birmingham, Ala. Electronic address: aahmed@uab.edu.
Robert C BourgeUniversity of Alabama at Birmingham, Birmingham, Ala.
Gregg C FonarowUniversity of California, Los Angeles, Calif.
Kanan PatelUniversity of Alabama at Birmingham, Birmingham, Ala.
Charity J MorganUniversity of Alabama at Birmingham, Birmingham, Ala.
Jerome L FlegNational Heart, Lung, and Blood Institute, Bethesda, Md.
Inmaculada B AbanUniversity of Alabama at Birmingham, Birmingham, Ala.
Thomas E LoveCase Western Reserve University, Cleveland, Ohio.
Clyde W YancyNorthwestern University, Chicago, Ill.
Prakash DeedwaniaUniversity of California, San Francisco, Fresno, Calif.
Dirk J van VeldhuisenUniversity of Groningen, Groningen, the Netherlands.
Gerasimos S FilippatosAttikon University Hospital, Athens, Greece.
Stefan D AnkerApplied Cachexia Research, Charité, Campus Virchow-Klinikum, Berlin, Germany.
Richard M AllmanUniversity of Alabama at Birmingham, Birmingham, Ala; Veterans Affairs Medical Center, Birmingham, Ala.
University of Alabama at Birmingham · USCase Western Reserve University · USCharité - Universitätsmedizin Berlin · DENational Heart Lung and Blood Institute · USNorthwestern University · PHUniversity General Hospital Attikon · GRUniversity of California, Los Angeles · USUniversity of California, San Francisco · USUniversity of Groningen · NL

Funding

University of Alabama at Birmingham's Diabetes Research CenterP30DK079626 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Kirk Michael Habegger · 2013 to 2026
$19.5M
UAB Center for Clinical and Translational Science (CCTS) UL1UL1TR000165 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI KIMBERLY, ROBERT P. · 2012 to 2013
$9.6M
Heart failure, chronic kidney disease, and renin-angiotensin system inhibitionR01HL085561 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2006 to 2009
$1.5M
Neurohormonal Blockade and Outcomes in Diastolic Heart FailureR01HL097047 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2009 to 2010
$915k
NCATS NIH HHS UL1 TR000165NHLBI NIH HHS R01 HL085561NHLBI NIH HHS R01-HL085561NHLBI NIH HHS R01-HL085561-SNHLBI NIH HHS R01 HL097047NHLBI NIH HHS R01-HL097047NIDDK NIH HHS P30 DK079626
6 · The paper itself

Abstract

backgroundHeart failure is the leading cause for hospital readmission, the reduction of which is a priority under the Affordable Care Act. Digoxin reduces 30-day all-cause hospital admission in chronic systolic heart failure. Whether digoxin is effective in reducing readmission after hospitalization for acute decompensation remains unknown.

methodsOf the 5153 Medicare beneficiaries hospitalized for acute heart failure and not receiving digoxin, 1054 (20%) received new discharge prescriptions for digoxin. Propensity scores for digoxin use, estimated for each of the 5153 patients, were used to assemble a matched cohort of 1842 (921 pairs) patients (mean age, 76 years; 56% women; 25% African American) receiving and not receiving digoxin, who were balanced on 55 baseline characteristics.

resultsThirty-day all-cause readmission occurred in 17% and 22% of matched patients receiving and not receiving digoxin, respectively (hazard ratio [HR] for digoxin, 0.77; 95% confidence interval [CI], 0.63-0.95). This beneficial association was observed only in those with ejection fraction <45% (HR 0.63; 95% CI, 0.47-0.83), but not in those with ejection fraction ≥ 45% (HR 0.91; 95% CI, 0.60-1.37; P for interaction, .145), a difference that persisted throughout the first 12 months postdischarge (P for interaction, .019). HRs (95% CIs) for 12-month heart failure readmission and all-cause mortality were 0.72 (0.61-0.86) and 0.83 (0.70-0.98), respectively.

conclusionsIn Medicare beneficiaries with systolic heart failure, a discharge prescription of digoxin was associated with lower 30-day all-cause hospital readmission, which was maintained at 12 months, and was not at the expense of higher mortality. Future randomized controlled trials are needed to confirm these findings.

Indexed as

MedicareAgedAged, 80 and overCardiotonic AgentsCase-Control StudiesChronic DiseaseDigoxinDrug Administration ScheduleFemaleHeart Failure, SystolicHumansMalePatient DischargePatient ReadmissionTreatment OutcomeUnited StatesCardiotonic AgentsDigoxinDigoxinHeart failureHospital readmission

Identifiers

PMID24257326
PMCPMC3929967
OpenAlexW2106236004

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.