PMID- 27533758
OWN - NLM
STAT- MEDLINE
DCOM- 20180323
LR  - 20180323
IS  - 2055-6845 (Electronic)
VI  - 2
IP  - 3
DP  - 2016 Jul
TI  - Effects of digitalis on mortality in a large cohort of implantable cardioverter 
      defibrillator recipients: results of a long-term follow-up study in 1020 
      patients.
PG  - 168-74
LID - 10.1093/ehjcvp/pvw008 [doi]
AB  - AIMS: The effects of digitalis on mortality in patients with structural heart 
      disease are controversially discussed. We aimed to assess the effects of 
      digitalis administration in implantable cardioverter defibrillator (ICD) 
      recipients. METHODS AND RESULTS: This retrospective analysis comprises 1020 
      consecutive patients who received an ICD at our institution and who were followed 
      for up to 10 years (median 37 months). A total of 438 patients were receiving 
      digitalis at the time of ICD implantation and 582 did not. Patients on digitalis 
      were more often in atrial fibrillation and had more often a prolonged QRS 
      duration of >/=120 ms, a severely impaired left ventricular ejection fraction, and 
      higher New York Heart Association (NYHA) classification heart failure. Crude 
      Kaplan-Meier analysis demonstrated significantly higher mortality in patients on 
      digitalis (HR = 2.47; 95% CI 1.87-3.25; P = 0.001). After adjustment for patient 
      characteristics found statistically significant in adjusted Cox regression 
      analysis (age, gender, NYHA classification, and QRS duration of >/=120 ms), a HR of 
      1.65 remained (95% CI 1.14-2.39; P = 0.01). Patients on digitalis died more often 
      from cardiac arrhythmic and cardiac non-arrhythmic causes than patients not on 
      digitalis (P = 0.04). There was no difference in mortality between patients 
      receiving digitoxin and those receiving digoxin (HR = 1.55; 95% CI 0.74-3.25; P = 
      0.25). CONCLUSION: In this large ICD patient population, digitalis use at 
      baseline was independently associated with increased mortality even after careful 
      adjustment for possible confounders. Digitalis should be used with great caution 
      in this population.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2016. For permissions please email: journals.permissions@oup.com.
FAU - Erath, Julia W
AU  - Erath JW
AD  - Division of Clinical Electrophysiology, Department of Cardiology, J.W. Goethe 
      University, Theodor-Stern-Kai 7, D 60590 Frankfurt am Main, Germany.
FAU - Vamos, Mate
AU  - Vamos M
AD  - Division of Clinical Electrophysiology, Department of Cardiology, J.W. Goethe 
      University, Theodor-Stern-Kai 7, D 60590 Frankfurt am Main, Germany.
FAU - Hohnloser, Stefan H
AU  - Hohnloser SH
AD  - Division of Clinical Electrophysiology, Department of Cardiology, J.W. Goethe 
      University, Theodor-Stern-Kai 7, D 60590 Frankfurt am Main, Germany 
      hohnloser@em.uni-frankfurt.de.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20160403
PL  - England
TA  - Eur Heart J Cardiovasc Pharmacother
JT  - European heart journal. Cardiovascular pharmacotherapy
JID - 101669491
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Digitalis Glycosides)
RN  - 73K4184T59 (Digoxin)
RN  - E90NZP2L9U (Digitoxin)
SB  - IM
CIN - Eur Heart J Cardiovasc Pharmacother. 2017 Jul 1;3(3):127-128. PMID: 28206589
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/*drug therapy/mortality/*surgery
MH  - Cardiotonic Agents/*adverse effects/*therapeutic use
MH  - Cohort Studies
MH  - *Defibrillators, Implantable
MH  - Digitalis Glycosides/*adverse effects/blood/*therapeutic use
MH  - Digitoxin/adverse effects/therapeutic use
MH  - Digoxin/adverse effects/therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*drug therapy/mortality/*surgery
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - Congestive heart failure
OT  - Digitalis
OT  - ICD
OT  - Mortality
EDAT- 2016/08/18 06:00
MHDA- 2018/03/24 06:00
CRDT- 2016/08/18 06:00
PHST- 2016/01/10 00:00 [received]
PHST- 2016/03/30 00:00 [accepted]
PHST- 2016/08/18 06:00 [entrez]
PHST- 2016/08/18 06:00 [pubmed]
PHST- 2018/03/24 06:00 [medline]
AID - pvw008 [pii]
AID - 10.1093/ehjcvp/pvw008 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Pharmacother. 2016 Jul;2(3):168-74. doi: 
      10.1093/ehjcvp/pvw008. Epub 2016 Apr 3.