Evidence map›Paper›PMID 29569405›Full record

Trial reportClinical cardiology2018

Digoxin use and lower risk of 30-day all-cause readmission in older patients with heart failure and reduced ejection fraction receiving β-blockers.

Phillip H Lam, Poonam Bhyan, Cherinne Arundel, Daniel J Dooley, Helen M Sheriff, Selma F Mohammed, Gregg C Fonarow, Charity J Morgan, Wilbert S Aronow, Richard M Allman and 2 more

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
1.5field-weighted citation impact, top 16% 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

14 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 3 countries.

Phillip H LamDepartment of Medicine, Veterans Affairs Medical Center, Washington, D.C.
Poonam BhyanDepartment of Medicine, Veterans Affairs Medical Center, Washington, D.C.
Cherinne ArundelDepartment of Medicine, Veterans Affairs Medical Center, Washington, D.C.
Daniel J DooleyDepartment of Medicine, Veterans Affairs Medical Center, Washington, D.C.
Helen M SheriffDepartment of Medicine, Veterans Affairs Medical Center, Washington, D.C.
Selma F MohammedMedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, D.C.
Gregg C FonarowAhmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles.ORCID http://orcid.org/0000-0002-3192-8093
Charity J MorganDepartment of Biostatistics, University of Alabama at Birmingham.
Wilbert S AronowDepartment of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York.ORCID http://orcid.org/0000-0002-7945-9863
Richard M AllmanOffice of Geriatrics and Extended Care, Department of Veterans Affairs, Washington, D.C.
Finn WaagsteinDepartment of Medicine, University of Gothenburg, Gothenburg, Sweden.
Ali AhmedDepartment of Medicine, Veterans Affairs Medical Center, Washington, D.C.ORCID http://orcid.org/0000-0002-6832-6424
MedStar Washington Hospital Center · USGeorge Washington University · USDepartment of Veterans Affairs · AUUniversity of Alabama at Birmingham · USUniversity of California, Los Angeles · USUniversity of Gothenburg · SEWestchester Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDigoxin use has been associated with a lower risk of 30-day all-cause admission and readmission in patients with heart failure and reduced ejection fraction (HFrEF). HYPOTHESIS: Digoxin use will be associated with improved outcomes in patients with HFrEF receiving β-blockers.

methodsOf the 3076 hospitalized Medicare beneficiaries with HFrEF (EF <45%), 1046 received a discharge prescription for β-blockers, of which 634 were not on digoxin. Of the 634, 204 received a new discharge prescription for digoxin. Propensity scores for digoxin use, estimated for each of the 634 patients, were used to assemble a matched cohort of 167 pairs of patients receiving and not receiving digoxin, balanced on 30 baseline characteristics. Matched patients (n = 334) had a mean age of 74 years and were 46% female and 30% African American.

results30-day all-cause readmission occurred in 15% and 27% of those receiving and not receiving digoxin, respectively (hazard ratio [HR]: 0.51, 95% confidence interval [CI]: 0.31-0.83, P = 0.007). This beneficial association persisted during 4 years of follow-up (HR: 0.72, 95% CI: 0.57-0.92, P = 0.008). Digoxin use was also associated with a lower risk of the combined endpoint of all-cause readmission or all-cause mortality at 30 days (HR: 0.54, 95% CI: 0.34-0.86, P = 0.009) and at 4 years (HR: 0.76, 95% CI: 0.61-0.96, P = 0.020).

conclusionsIn hospitalized patients with HFrEF receiving β-blockers, digoxin use was associated with a lower risk of 30-day all-cause readmission but not mortality, which persisted during longer follow-up.

Indexed as

Adrenergic beta-AntagonistsAgedAlabamaCardiotonic AgentsDigoxinDose-Response Relationship, DrugDrug Therapy, CombinationEchocardiographyFemaleFollow-Up StudiesHeart FailureHeart VentriclesHospital MortalityHumansMalePatient ReadmissionAdrenergic beta-AntagonistsCardiotonic AgentsDigoxinDigoxinHeart FailureHospital Readmissionβ-Blockers

Identifiers

PMID29569405
PMCPMC6489941
OpenAlexW2790194299

What OpenQuestion holds

Textmetadata
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.