Key result
In women with heart failure, digoxin use independently predicted all-cause mortality (HR 1.20; 95% CI 1.02-1.42), while ACE inhibitor use predicted lower hospitalization (HR 0.67; 95% CI 0.49-0.91).
Why the study?
What are the independent predictors of mortality and hospitalization in women with heart failure?
Cohort (n=1,926)
What are the independent predictors of mortality and hospitalization in women with heart failure?
In women with heart failure, longer duration of HF, higher NYHA class, diabetes, chronic kidney disease, pulmonary congestion, and lower LVEF are significant independent predictors of mortality and hospitalization.
May warrant caution with digoxin in women with HF; leaves open confirmation of sex-specific effects in randomized trials.
We performed a retrospective follow-up study of 1926 women with heart failure who participated in the Digitalis Investigation Group trial. Adjusted hazard ratios and 95% confidence intervals for covariates that were significant independent predictors of all-cause mortality were age in years (1.02; 1.01-1.03; P<0.001), NYHA class IH-IV (1.56; 1.31-1.87), diabetes (1.63; 1.36-1.95), glomerular filtration rate in mL/min/1.73 m(2) (0.99; 0.98-4).996; P=0.001), pulmonary congestion by chest x-ray (1.57; 1.22-2.02), left ventricular ejection fraction (LVEF) (0.99; 0.98-0.993; P<0.001), and use of digoxin (1.20; 1.02-1.42). Covariates that were significant independent predictors of hospitalization due to worsening heart failure were: nonwhite race (1.28; 1.03-1.58), NYHA class III-IV (1.55; 1.30-1.84), diabetes (1.75; 1.47-2.09), glomerular filtration rate as mL/min/1.73 m(2) (0.99; 0.986-0.996; P<0.001), pulmonary congestion by chest x-ray (1.42; 1.12-1.81), and use of ACE inhibitors (0.67; 0.49-0.91). Longer duration of heart failure, higher NYHA classes, diabetes, chronic kidney disease, pulmonary congestion, and lower LVEF were significant independent predictors of all-cause mortality, all-cause hospitalization, and hospitalization for heart failure in women with heart failure.
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Ahmed et al. (2006) conducted a cohort in Heart failure (n=1,926). Clinical and demographic predictors was evaluated on All-cause mortality and hospitalization due to worsening heart failure. In women with heart failure, digoxin use independently predicted all-cause mortality (HR 1.20; 95% CI 1.02-1.42), while ACE inhibitor use predicted lower hospitalization (HR 0.67; 95% CI 0.49-0.91).
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