Key result
High serum digoxin concentrations (1.2 to 2 ng/mL) were associated with a significantly increased risk of mortality compared to lower concentrations (0.5 to 1.1 ng/mL) in male patients (HR 1.656; 95% CI 1.153-2.38; P=0.0063).
Cohort (n=261)
Effect estimate: HR 1.656 (95% CI 1.153 to 2.38)
p-value: p=0.0063
High digoxin levels associated with mortality in men; supports DIG trial observations but hypothesis-generating and should not yet change practice.
Background There are data suggesting a possible association of serum digoxin concentrations (SDC) and risk of mortality in patients treated with digoxin. Objective To determine whether SDCs in the therapeutic range of 1.2 to 2 ng/mL increase the risk of mortality when compared to a lower range of 0.5 to 1.1 ng/mL. Methods Retrospective cohort study to compare the risk of mortality in male patients with SDCs less than 1.2 ng/mL to patients with SDCs of 1.2 to 2 ng/mL. Results A total of 261 male patients were included, 191 (73%) had SDCs in the low range (0.5 to 1.1 ng/mL), and 70 (27%) had SDCs in the high range (at least 1.2 to 2 ng/mL). A high SDC showed a significant increase in risk for mortality with a hazard ratio (HR) of 1.656; 95 % HR confidence interval, 1.153 to 2.38; P = 0.0063. Conclusion Our results showed an increased risk of mortality in the high SDC group (1.2 to 2 ng/mL). This study's findings are consistent with the results of a post hoc evaluation of SDC in male patients in the DIG trial. 1 A prospective trial is warranted to confirm our findings.
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Rising et al. (2006) conducted a cohort in Patients treated with digoxin (n=261). High serum digoxin concentration (SDC) vs. Low SDC (0.5 to 1.1 ng/mL) was evaluated on Mortality (HR 1.656, 95% CI 1.153 to 2.38, p=0.0063). High serum digoxin concentrations (1.2 to 2 ng/mL) were associated with a significantly increased risk of mortality compared to lower concentrations (0.5 to 1.1 ng/mL) in male patients (HR 1.656; 95% CI 1.153-2.38; P=0.0063).
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