Evidence map›Paper›PMID 31150644›Full record

ArticleThe American journal of medicine2019

Digoxin Use and Outcomes in Patients With Heart Failure With Reduced Ejection Fraction.

Syed Z Qamer, Awais Malik, Essraa Bayoumi, Phillip H Lam, Steven Singh, Milton Packer, Ioannis E Kanonidis, Charity J Morgan, Ahmed Abdelmawgoud, Richard M Allman and 2 more

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Article in The American journal of medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
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

11 citing papers in PubMed.

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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.

Syed Z QamerVeterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC.
Awais MalikVeterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC.
Essraa BayoumiVeterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC; MedStar Washington Hospital Center, Washington, DC.
Phillip H LamVeterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC; MedStar Washington Hospital Center, Washington, DC.
Steven SinghVeterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC.
Milton PackerBaylor University Medical Center, Dallas, TX.
Ioannis E KanonidisAristotle University, Thessaloniki, Greece.
Charity J MorganUniversity of Alabama at Birmingham.
Ahmed AbdelmawgoudAin Shams University, Cairo, Egypt.
Richard M AllmanGeorge Washington University, Washington, DC.
Gregg C FonarowUniversity of California, Los Angeles.
Ali AhmedVeterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC; George Washington University, Washington, DC. Electronic address: ali.ahmed@va.gov.

Funding

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
NHLBI NIH HHS R01 HL085561NHLBI NIH HHS R01 HL097047
6 · The paper itself

Abstract

backgroundHeart failure is a leading cause for hospital readmission. Digoxin use may lower this risk in patients with heart failure with reduced ejection fraction (HFrEF), but data on contemporary patients receiving other evidence-based therapies are lacking.

methodsOf the 11,900 patients with HFrEF (ejection fraction ≤45%) in Medicare-linked OPTIMIZE-HF, 8401 were not on digoxin, of whom 1571 received discharge prescriptions for digoxin. We matched 1531 of these patients with 1531 not receiving digoxin by propensity scores for digoxin use. The matched cohort (n = 3062; mean age, 76 years; 44% women; 14% African American) was balanced on 52 baseline characteristics. We assembled a second matched cohort of 2850 patients after excluding those with estimated glomerular filtration rate <15 mL/min/1.73 m

resultsAmong the 3062 matched patients, digoxin use was associated with a significantly lower risk of heart failure readmission at 30 days (HR, 0.74; 95% CI, 0.59-0.93), 1 year (HR, 0.81; 95% CI, 0.72-0.92), and 6 years (HR, 0.90; 95% CI 0.81-0.99). The association with all-cause readmission was significant at 1 and 6 years but not 30 days. There was no association with mortality. Similar associations were observed among the 2850 matched patients without bradycardia or renal insufficiency.

conclusionsAmong hospitalized older patients with HFrEF receiving contemporary treatments for heart failure, digoxin use is associated with a lower risk of hospital readmission but not all-cause mortality.

Indexed as

HospitalizationAgedCardiotonic AgentsCause of DeathDigoxinFemaleHeart FailureHumansMaleMedicarePatient ReadmissionPropensity ScoreStroke VolumeUnited StatesCardiotonic AgentsDigoxinDigoxinHeart failure with reduced ejection fractionHospital readmission

Identifiers

PMID31150644
PMCPMC10463227

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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.