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 journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Medicine(all)

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