{
    "abstract": "Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) are common cardiovascular conditions linked to significant health burdens. This review aims to study the relationship of serum digoxin concentration and mortality and morbidity outcomes in defined population.\nWe conducted a thorough search of databases such as PubMed, Google Scholar, and Cochrane Library, from inception until 20th Aug 2023. Studies that explored the relationship between serum digoxin concentration and mortality, morbidity, or other clinical endpoints in AF and HFrEF patients (ejection fraction \u226445\u00a0%) were eligible for inclusion.\nThe selected studies exhibited a wide range of designs, patient cohorts, and measured outcomes. The association between serum digoxin concentration, mortality and morbidity endpoints like hospitalization rates and cardiovascular events were assessed in these studies. Despite the methodological diversity, our systematic review uncovered consistent trends across the studies, suggesting that elevated serum digoxin concentrations may correlate with higher mortality and morbidity in AF and HFrEF patients.\nThis systematic review emphasizes the need for cautious management of serum digoxin levels in patients with concurrent AF and HFrEF. While digoxin remains a valuable treatment for heart failure, its potential adverse effects on outcomes in this specific patient subgroup call for vigilant monitoring and individualized treatment approaches. Further research is required to elucidate the dose-response relationship and potential confounding factors influencing outcomes associated with serum digoxin concentration in AF and HFrEF patients. Clinicians should consider these findings when making therapeutic decisions to enhance patient care and outcomes.",
    "authors": [
        {
            "affiliation": "Research student, National University of Medical Sciences, CMH Kharian Medical College, 50090, Pakistan.",
            "firstname": "Saman",
            "initials": "S",
            "lastname": "Javid"
        },
        {
            "affiliation": "Department of Internal Medicine, Medical College Baroda, M.S. University, Vadodara 390001, India.",
            "firstname": "Namra Vinay",
            "initials": "NV",
            "lastname": "Gohil"
        },
        {
            "affiliation": "Assistant professor of Cardiology, Cardiology Department Sahara Medical College, Narowal 51600, Pakistan.",
            "firstname": "Shabahat",
            "initials": "S",
            "lastname": "Ali"
        },
        {
            "affiliation": "Andhra Medical College, India.",
            "firstname": "Adarsh Vardhan",
            "initials": "AV",
            "lastname": "Tangella"
        },
        {
            "affiliation": "Researcher, Medical Officer, Sangani Hospital Keshod, 362220, India.",
            "firstname": "Mohmed Junaid Hasim",
            "initials": "MJH",
            "lastname": "Hingora"
        },
        {
            "affiliation": "General practitioner, ER, and Inpatient, Al Emadi Hospital Doha, Qatar.",
            "firstname": "M A",
            "initials": "MA",
            "lastname": "Hussam"
        },
        {
            "affiliation": "Osmania Medical College, Hyderabad, India.",
            "firstname": "Mahek",
            "initials": "M",
            "lastname": "Fatima"
        },
        {
            "affiliation": "Medical officer, Clinical Skills Lab, Ziauddin Medical University Karachi, 75600, Pakistan.",
            "firstname": "Ayesha Farooq",
            "initials": "AF",
            "lastname": "Alam"
        },
        {
            "affiliation": "Department of Internal Medicine, Metropolitan Hospital Center, New York, NY 10029, USA.",
            "firstname": "Yamama",
            "initials": "Y",
            "lastname": "Al-Khazraji"
        },
        {
            "affiliation": "King Edward Medical University, Lahore 54000, Pakistan.",
            "firstname": "Muhammad Nabeel",
            "initials": "MN",
            "lastname": "Saddique"
        },
        {
            "affiliation": "Institution- University of Huddersfield, United Kingdom.",
            "firstname": "Arbaz",
            "initials": "A",
            "lastname": "Ashraf"
        },
        {
            "affiliation": "Health Services Academy, Islamabad, Pakistan. Electronic address: Hassanmumtaz.dr@gmail.com.",
            "firstname": "Hassan",
            "initials": "H",
            "lastname": "Mumtaz"
        },
        {
            "affiliation": "Central Park Medical College, Lahore, Pakistan.",
            "firstname": "Amna",
            "initials": "A",
            "lastname": "Liaquat"
        }
    ],
    "conclusions": "This systematic review emphasizes the need for cautious management of serum digoxin levels in patients with concurrent AF and HFrEF. While digoxin remains a valuable treatment for heart failure, its potential adverse effects on outcomes in this specific patient subgroup call for vigilant monitoring and individualized treatment approaches. Further research is required to elucidate the dose-response relationship and potential confounding factors influencing outcomes associated with serum digoxin concentration in AF and HFrEF patients. Clinicians should consider these findings when making therapeutic decisions to enhance patient care and outcomes.",
    "copyrights": "Copyright \u00a9 2023 Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.cpcardiol.2023.102218",
    "journal": "Current problems in cardiology",
    "keywords": [
        "Atrial fibrillation",
        "Digoxin",
        "Ejection fraction",
        "Heart failure",
        "Morbidity",
        "Mortality"
    ],
    "methods": null,
    "publication_date": "2023-11-25",
    "pubmed_id": "38000566",
    "results": "The selected studies exhibited a wide range of designs, patient cohorts, and measured outcomes. The association between serum digoxin concentration, mortality and morbidity endpoints like hospitalization rates and cardiovascular events were assessed in these studies. Despite the methodological diversity, our systematic review uncovered consistent trends across the studies, suggesting that elevated serum digoxin concentrations may correlate with higher mortality and morbidity in AF and HFrEF patients.",
    "title": "Association of serum digoxin concentration with morbidity and mortality in patients with atrial fibrillation, heart failure and reduced ejection fraction of 45 % or below.",
    "xml": "<Element 'PubmedArticle' at 0x78850321b600>"
}