Digoxin reduces 30-day all-cause hospital admission in older patients with chronic systolic heart failure

Robert C. Bourge, Jerome L. Fleg, Gregg C. Fonarow, John G F Cleland, John J V McMurray, Dirk J. Van Veldhuisen, Mihai Gheorghiade, Kanan Patel, Inmaculada B. Aban, Richard M. Allman, Connie White-Williams, Michel White, Gerasimos S. Filippatos, Stefan D. Anker, Ali Ahmed

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: Heart failure is a leading cause of hospital admission and readmission in older adults. The new United States healthcare reform law has created provisions for financial penalties for hospitals with higher than expected 30-day all-cause readmission rates for hospitalized Medicare beneficiaries aged ≥65 years with heart failure. We examined the effect of digoxin on 30-day all-cause hospital admission in older patients with heart failure and reduced ejection fraction. Methods: In the main Digitalis Investigation Group trial, 6800 ambulatory patients with chronic heart failure (ejection fraction ≤45%) were randomly assigned to digoxin or placebo. Of these, 3405 were aged ≥65 years (mean age, 72 years; 25% were women; 11% were nonwhite). The main outcome in the current analysis was 30-day all-cause hospital admission. Results: In the first 30 days after randomization, all-cause hospitalization occurred in 5.4% (92/1693) and 8.1% (139/1712) of patients in the digoxin and placebo groups, respectively, (hazard ratio {HR} when digoxin was compared with placebo, 0.66; 95% confidence interval {CI}, 0.51-0.86; P =.002). Digoxin also reduced both 30-day cardiovascular (3.5% vs 6.5%; HR, 0.53; 95% CI, 0.38-0.72; P

Original languageEnglish
Pages (from-to)701-708
Number of pages8
JournalAmerican Journal of Medicine
Volume126
Issue number8
DOIs
Publication statusPublished - Aug 2013

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Systolic Heart Failure
Digoxin
Heart Failure
Placebos
Confidence Intervals
Patient Readmission
Health Care Reform
Digitalis
Random Allocation
Medicare
Hospitalization

Keywords

  • 30-day all-cause hospital admission
  • Digoxin
  • Heart failure

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Bourge, R. C., Fleg, J. L., Fonarow, G. C., Cleland, J. G. F., McMurray, J. J. V., Van Veldhuisen, D. J., ... Ahmed, A. (2013). Digoxin reduces 30-day all-cause hospital admission in older patients with chronic systolic heart failure. American Journal of Medicine, 126(8), 701-708. https://doi.org/10.1016/j.amjmed.2013.02.001

Digoxin reduces 30-day all-cause hospital admission in older patients with chronic systolic heart failure. / Bourge, Robert C.; Fleg, Jerome L.; Fonarow, Gregg C.; Cleland, John G F; McMurray, John J V; Van Veldhuisen, Dirk J.; Gheorghiade, Mihai; Patel, Kanan; Aban, Inmaculada B.; Allman, Richard M.; White-Williams, Connie; White, Michel; Filippatos, Gerasimos S.; Anker, Stefan D.; Ahmed, Ali.

In: American Journal of Medicine, Vol. 126, No. 8, 08.2013, p. 701-708.

Research output: Contribution to journalArticle

Bourge, RC, Fleg, JL, Fonarow, GC, Cleland, JGF, McMurray, JJV, Van Veldhuisen, DJ, Gheorghiade, M, Patel, K, Aban, IB, Allman, RM, White-Williams, C, White, M, Filippatos, GS, Anker, SD & Ahmed, A 2013, 'Digoxin reduces 30-day all-cause hospital admission in older patients with chronic systolic heart failure', American Journal of Medicine, vol. 126, no. 8, pp. 701-708. https://doi.org/10.1016/j.amjmed.2013.02.001
Bourge, Robert C. ; Fleg, Jerome L. ; Fonarow, Gregg C. ; Cleland, John G F ; McMurray, John J V ; Van Veldhuisen, Dirk J. ; Gheorghiade, Mihai ; Patel, Kanan ; Aban, Inmaculada B. ; Allman, Richard M. ; White-Williams, Connie ; White, Michel ; Filippatos, Gerasimos S. ; Anker, Stefan D. ; Ahmed, Ali. / Digoxin reduces 30-day all-cause hospital admission in older patients with chronic systolic heart failure. In: American Journal of Medicine. 2013 ; Vol. 126, No. 8. pp. 701-708.
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