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Erschienen in: Wiener klinische Wochenschrift 21-22/2021

08.12.2020 | original article

Association of digoxin therapy with case fatality rate in acute pulmonary embolism

verfasst von: M.D. Mehmet Baran Karataş, M.D. Nizamettin Selçuk Yelgeç, M.D. Yiğit Çanga, M.D. Ahmet Zengin, M.D. Ayşe Emre

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 21-22/2021

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Summary

Objective

Despite wide usage of digoxin for various diseases in cardiology practice, its benefit is controversial and moreover it had been associated with unfavorable outcomes in some previous studies. The aim of this present study was to demonstrate whether digoxin usage was related with worse outcomes or not in patients with acute pulmonary embolisms.

Methods

A total number of 1215 patients retrospectively enrolled for the study. Basic demographic features, pulmonary embolism severity index (PESI) scores, laboratory parameters and medications of patients who had been diagnosed with acute pulmonary embolism were recorded. Short (30 days) and long-term mortality were reported as the clinical outcomes.

Results

Total mortality was 15.4% in the study population and 78 of these subjects died within the first 30 days. The frequency of digoxin treatment was 8% and most of these patients were prior users. According to the binary logistic regression analyses the PESI score, right ventricle (RV) diastolic diameter, systolic pulmonary arterial pressure (sPAP), brain natriuretic peptide (BNP), troponin and digoxin therapy (odds ratio, OR: 2.82 95% confidence interval, CI: 1.39–8.31, P = 0.03) were found as independent predictors of short-term mortality. Beside these findings; sPAP, PESI score, RV diastolic diameter and digoxin therapy (hazard ratio, HR: 2.11 95%CI: 1.22–7.31, P = 0.03) were determined as independent predictors of long-term mortality in Cox regression analyses. In subgroup analysis, we determined significantly greater increase in short-term mortality with use of digoxin among patients who had chronic renal disease, among patients under thrombolytic therapy and under high dosage of digoxin therapy and among female patients.

Conclusion

Digoxin has been used extensively for decades in the treatment of heart failure and arrhythmias despite some controversies over its benefit. For the first time in the literature, we have demonstrated independent association of digoxin therapy with short-term and long-term mortality in patients with acute pulmonary embolism.

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Metadaten
Titel
Association of digoxin therapy with case fatality rate in acute pulmonary embolism
verfasst von
M.D. Mehmet Baran Karataş
M.D. Nizamettin Selçuk Yelgeç
M.D. Yiğit Çanga
M.D. Ahmet Zengin
M.D. Ayşe Emre
Publikationsdatum
08.12.2020
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 21-22/2021
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-020-01773-z