March 1, 1994European Heart Journal
Chrome congestive heart failure
Why the study?
Does digoxin treatment increase the risk of death in hospital survivors of acute myocardial infarction?
Population
584 hospital survivors of acute myocardial infarction
Comparison
Digoxin treatment vs No digoxin treatment
Design
Cohort
Follow-up
median 6.2 years (range 3.9-7.8 years)
Authors
Discussion
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Member takes
Implication
May warrant caution with digoxin post-MI; leaves open causality and need for RCTs.
Key Points
- This study aims to evaluate the safety of digoxin treatment in patients who survived an acute myocardial infarction.
- Analyzed data from 584 hospital survivors of myocardial infarction with follow-up of 6.2 years (median)
- Assessed left ventricular ejection fraction using radionuclide ventriculography
- Conducted proportional hazard model analysis including various covariates.
- 1-year and 5-year mortality in patients treated with digoxin was 38% and 74% compared to 8% and 26% in those not treated with digoxin (P < 0.001)
- Digoxin treatment was associated with a relative risk of death of 1.8 (95% CI 1.2-2.5)
- Patients treated with digoxin had a significantly lower left ventricular ejection fraction (0.33 vs 0.49; P < 0.001).
Structured PICO
Does digoxin treatment increase the risk of death in hospital survivors of acute myocardial infarction?
P
Population
584 hospital survivors of acute myocardial infarction
I
Intervention
Digoxin treatment
C
Comparator
No digoxin treatment
O
Outcome
Death (all-cause mortality) at median 6.2 years follow-uphard clinical
In hospital survivors of acute myocardial infarction, digoxin therapy is independently associated with an 80% increased relative risk of death, suggesting it may be harmful in this population.
Cite This Study
Køber et al. (1994) studied this question.