{
    "abstract": "Digoxin is commonly used to treat acute heart failure (AHF), especially in patients with concurrent atrial fibrillation (AF). Nonetheless, there is little consensus about in which patients digoxin should be given, the proper time for digoxin initiation, and whether digoxin initiation is associated with improved outcomes. We investigated factors related to digoxin initiation after an episode of AHF and whether patients receiving digoxin presented better short-term outcomes. We analyzed digoxin-na\u00efve AHF patients from a Spanish and Swiss database, who were dichotomized into cohorts based on their receipt of digoxin treatment at discharge. The relationship between digoxin initiation and 23 additional patient covariates, including chronic treatment, was investigated, as well as its association with 90-day combined adverse events (defined as all-cause death or AHF hospitalization). Of 13,105 patients (10,600/2505 from the Spanish/Swiss cohorts, respectively), the median (interquartile range) age was 83 (74.87) years, and 51% were women. Of these, 484 (3.7%) received digoxin at discharge, which was associated with AF, female sex, left ventricular ejection fraction (LVEF)\u2009<\u200950%, and coming from the Spanish cohort. Parameters inversely associated with receiving digoxin at discharge included some chronic treatments, diabetes mellitus (DM), and chronic kidney disease (CKD). Digoxin initiation was not association with 90-day adverse events, adjusted hazard ratio (aHR)\u2009=\u20090.939 (0.769-1.146), but there was an interaction for CKD, aHR\u2009=\u20091.390 (0.831-2.325) vs. 0.854 (0.682-1.183), p\u2009=\u20090.039, and for cohort pertinence, with higher risk in the Swiss cohort; aHR\u2009=\u20091.405 (0.827-2.386) vs. 0.862 (0.689-1.077), p\u2009=\u20090.046. Digoxin initiation after an AHF episode was more frequent in the Spanish cohort and was associated with certain patient characteristics (AF, female sex, reduced LVEF, no DM, no CKD), but had no effect on 90-day outcomes.",
    "authors": [
        {
            "affiliation": "Emergency Department, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain. omiro@clinic.cat.\nThe GREAT Network, Rome, Italy. omiro@clinic.cat.\nEmergency Department, Hospital Cl\u00ednic, Villarroel 170, 08036, Barcelona, Catalonia, Spain. omiro@clinic.cat.",
            "firstname": "\u00d2scar",
            "initials": "\u00d2",
            "lastname": "Mir\u00f3"
        },
        {
            "affiliation": "Emergency Department, Hospital Sant Pau I Santa Tecla, Tarragona, Catalonia, Spain.",
            "firstname": "Enrique Mart\u00edn",
            "initials": "EM",
            "lastname": "Mojarro"
        },
        {
            "affiliation": "The GREAT Network, Rome, Italy.\nCardiology Department, Cardiovascular Research Institute Basel (CRIB), University Hospital of Basel, University of Basel, Basel, Switzerland.",
            "firstname": "Gabrielle",
            "initials": "G",
            "lastname": "Hur\u00e9"
        },
        {
            "affiliation": "Emergency Medicine, Short Stay and Hospital at Home Departments, Hospital General d'Alacant, Alicante, Spain.",
            "firstname": "Pere",
            "initials": "P",
            "lastname": "Llorens"
        },
        {
            "affiliation": "Emergency Department, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain.",
            "firstname": "V\u00edctor",
            "initials": "V",
            "lastname": "Gil"
        },
        {
            "affiliation": "Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Catalonia, Spain.",
            "firstname": "Aitor",
            "initials": "A",
            "lastname": "Alqu\u00e9zar-Arb\u00e9"
        },
        {
            "affiliation": "Emergency Department, Hospital Infanta Leonor, Madrid, Spain.",
            "firstname": "Carlos",
            "initials": "C",
            "lastname": "Bibiano"
        },
        {
            "affiliation": "Emergency Department, Hospital Universitario de Gran Canaria Dr. Negr\u00edn, Las Palmas de Gran Canaria, Spain.",
            "firstname": "Nayra Cabrera",
            "initials": "NC",
            "lastname": "Gonz\u00e1lez"
        },
        {
            "affiliation": "Emergency Department, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain.",
            "firstname": "Marta",
            "initials": "M",
            "lastname": "Mass\u00f3"
        },
        {
            "affiliation": "The GREAT Network, Rome, Italy.\nCardiology Department, Cardiovascular Research Institute Basel (CRIB), University Hospital of Basel, University of Basel, Basel, Switzerland.",
            "firstname": "Ivo",
            "initials": "I",
            "lastname": "Strebel"
        },
        {
            "affiliation": "Emergency Medicine, Short Stay and Hospital at Home Departments, Hospital General d'Alacant, Alicante, Spain.",
            "firstname": "Bego\u00f1a",
            "initials": "B",
            "lastname": "Espinosa"
        },
        {
            "affiliation": "Emergency Department, Hospital del Mar, Barcelona, Catalonia, Spain.",
            "firstname": "Silvia M\u00ednguez",
            "initials": "SM",
            "lastname": "Mas\u00f3"
        },
        {
            "affiliation": "The GREAT Network, Rome, Italy.\nCardiology Department, Cardiovascular Research Institute Basel (CRIB), University Hospital of Basel, University of Basel, Basel, Switzerland.",
            "firstname": "Desiree",
            "initials": "D",
            "lastname": "Wussler"
        },
        {
            "affiliation": "The GREAT Network, Rome, Italy.\nCardiology Department, Cardiovascular Research Institute Basel (CRIB), University Hospital of Basel, University of Basel, Basel, Switzerland.",
            "firstname": "Samyut",
            "initials": "S",
            "lastname": "Shrestha"
        },
        {
            "affiliation": "The GREAT Network, Rome, Italy.\nCardiology Department, Cardiovascular Research Institute Basel (CRIB), University Hospital of Basel, University of Basel, Basel, Switzerland.",
            "firstname": "Pedro",
            "initials": "P",
            "lastname": "Lopez-Ayala"
        },
        {
            "affiliation": "Emergency Department, Hospital de Bellvitge, Barcelona, Catalonia, Spain.",
            "firstname": "Javier",
            "initials": "J",
            "lastname": "Jacob"
        },
        {
            "affiliation": "Emergency Department, Hospital Universitario La Fe, Valencia, Spain.",
            "firstname": "Javier",
            "initials": "J",
            "lastname": "Mill\u00e1n"
        },
        {
            "affiliation": "Emergency Department, Hospital Doctor Gregorio Mara\u00f1\u00f3n, Madrid, Spain.",
            "firstname": "Juan Antonio",
            "initials": "JA",
            "lastname": "Andueza"
        },
        {
            "affiliation": "Emergency Department, Hospital Marqu\u00e9s de Valdecilla, Santander, Spain.",
            "firstname": "H\u00e9ctor",
            "initials": "H",
            "lastname": "Alonso"
        },
        {
            "affiliation": "Emergency Department, Hospital Sant Pau I Santa Tecla, Tarragona, Catalonia, Spain.",
            "firstname": "Silvia Larrondo",
            "initials": "SL",
            "lastname": "P\u00e0mies"
        },
        {
            "affiliation": "Emergency Department, Hospital Sant Pau I Santa Tecla, Tarragona, Catalonia, Spain.",
            "firstname": "Jaume Farr\u00e9",
            "initials": "JF",
            "lastname": "Cerd\u00e0"
        },
        {
            "affiliation": "Emergency Department, Hospital Sant Pau I Santa Tecla, Tarragona, Catalonia, Spain.",
            "firstname": "Celia Planco",
            "initials": "CP",
            "lastname": "Mart\u00ednez"
        },
        {
            "affiliation": "Emergency Department, Hospital Universitario Central de Asturias, Oviedo, Spain.",
            "firstname": "Pablo",
            "initials": "P",
            "lastname": "Herrero"
        },
        {
            "affiliation": "The GREAT Network, Rome, Italy.\nEmergency Department, Baylor College of Medicine, Houston, TX, USA.",
            "firstname": "W",
            "initials": "W",
            "lastname": "Frank Peacock"
        },
        {
            "affiliation": "The GREAT Network, Rome, Italy.\nCardiology Department, Cardiovascular Research Institute Basel (CRIB), University Hospital of Basel, University of Basel, Basel, Switzerland.",
            "firstname": "Christian",
            "initials": "C",
            "lastname": "Mueller"
        },
        {
            "affiliation": null,
            "firstname": null,
            "initials": null,
            "lastname": null
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s), under exclusive licence to Societ\u00e0 Italiana di Medicina Interna (SIMI).",
    "doi": "10.1007/s11739-024-03744-y\n10.1093/eurheartj/ehab368\n10.1093/eurheartj/ehad195\n10.1007/s10741-005-6127-6\n10.1016/j.amjopharm.2010.10.001\n10.1016/j.ijcard.2015.04.031\n10.1038/nrcardio.2015.14\n10.1002/ehf2.12021\n10.1016/j.amjmed.2020.02.040\n10.7326/M16-2726\n10.1111/joim.13565\n10.1002/ejhf.2767\n10.1016/S0140-6736(14)61836-5\n10.1016/j.jchf.2019.03.011\n10.1136/bmj.h4451\n10.1002/ejhf.1347\n10.1053/euhj.1998.1343\n10.1007/s00392-018-1261-z\n10.1002/ejhf.890\n10.1016/j.jacc.2015.04.045\n10.1016/j.ijcard.2016.02.074\n10.1093/europace/euab319\n10.2459/JCM.0000000000001283\n10.1371/journal.pone.0245620",
    "journal": "Internal and emergency medicine",
    "keywords": [
        "Acute heart failure",
        "Atrial fibrillation",
        "Hospitalization",
        "Mortality",
        "Outcome"
    ],
    "methods": null,
    "publication_date": "2024-08-23",
    "pubmed_id": "39174687\n34447992\n37622666\n15809815\n21335295\n25666406\n28834628\n32272101\n35357780\n28973663\n38116968\n37439419\n36065587\n36597828\n25749644\n31146874\n26321114\n31994361\n30536678\n10208787\n29728831\n28463462\n26112191\n26913372\n35025995\n34860198\n33449946\n36625690\n37350600",
    "results": null,
    "title": "Digoxin initiation after an acute heart failure episode and its association with post-discharge outcomes: an international multicenter analysis.",
    "xml": "<Element 'PubmedArticle' at 0x7885036228e0>"
}