Temporal Trends of Digoxin Use in Patients Hospitalized With Heart Failure. Analysis From the American Heart Association Get With The Guidelines-Heart Failure Registry.

Nish Patel, Christine Ju, Conrad Macon, Udho Thadani, Phillip Schulte, Adrian F. Hernandez, Deepak L. Bhatt, Javed Butler, Clyde W. Yancy, Gregg C. Fonarow

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives: The aim of this study was to assess temporal trends and factors associated with digoxin use at discharge among patients admitted with heart failure (HF). Background: Digoxin has class IIa recommendations for treating HF with reduced ejection fraction (HFrEF) in the United States. Digoxin use, temporal trends, and clinical characteristics of HF patients in current clinical practice in the United States have not been well studied. Methods: An observational analysis of 255,901 patients hospitalized with HF (117,761 with HFrEF and 138,140 with preserved EF [HFpEF]) from 398 hospitals participating in the Get With The Guidelines-HF registry between January 2005 and June 2014 was conducted to assess the temporal trends and factors associated with digoxin use. Results: Among 117,761 HFrEF patients, only 19.7% received digoxin at discharge. Digoxin prescriptions decreased from 33.1% in 2005 to 10.7% in 2014 (ptrend < 0.0001). Factors associated with digoxin use in HFrEF included atrial fibrillation (AF) (odds ratio [OR]: 2.14; 95% confidence intervals [CI]: 2.02 to 2.28), history of implantable cardioverter defibrillator use (OR: 1.39; 95% CI: 1.32 to 1.46), chronic obstructive pulmonary disease (OR: 1.13, 95% CI: 1.08 to 1.18), diabetes mellitus (OR: 1.10, 95% CI: 1.06 to 1.14), younger age (OR: 0.96, 95% CI: 0.95 to 0.97), lower blood pressure (OR: 0.96, 95% CI: 0.96 to 0.97), and having no history of renal insufficiency (OR: 0.91, 95% CI: 0.85 to 0.97). Use of digoxin in patients with HFpEF (n = 138,140) without AF was 9.8% in 2005, which decreased to 2.2% in 2014 (ptrend < 0.0001). Conclusions: One in 5 HFrEF patients received digoxin at discharge, with a significant downward temporal trend in use over the study period. Use of digoxin in HFpEF patients without AF was very low and decreased over the study period.

Original languageEnglish (US)
Pages (from-to)348-356
Number of pages9
JournalJACC: Heart Failure
Volume4
Issue number5
DOIs
StatePublished - May 1 2016
Externally publishedYes

Fingerprint

Digoxin
Registries
Heart Failure
Guidelines
Odds Ratio
Confidence Intervals
Atrial Fibrillation
Implantable Defibrillators
Patient Discharge
Chronic Obstructive Pulmonary Disease
Renal Insufficiency
Prescriptions
Diabetes Mellitus
Blood Pressure

Keywords

  • Digoxin
  • GWTG-HF
  • Heart failure
  • Trends

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Temporal Trends of Digoxin Use in Patients Hospitalized With Heart Failure. Analysis From the American Heart Association Get With The Guidelines-Heart Failure Registry. / Patel, Nish; Ju, Christine; Macon, Conrad; Thadani, Udho; Schulte, Phillip; Hernandez, Adrian F.; Bhatt, Deepak L.; Butler, Javed; Yancy, Clyde W.; Fonarow, Gregg C.

In: JACC: Heart Failure, Vol. 4, No. 5, 01.05.2016, p. 348-356.

Research output: Contribution to journalArticle

Patel, Nish ; Ju, Christine ; Macon, Conrad ; Thadani, Udho ; Schulte, Phillip ; Hernandez, Adrian F. ; Bhatt, Deepak L. ; Butler, Javed ; Yancy, Clyde W. ; Fonarow, Gregg C. / Temporal Trends of Digoxin Use in Patients Hospitalized With Heart Failure. Analysis From the American Heart Association Get With The Guidelines-Heart Failure Registry. In: JACC: Heart Failure. 2016 ; Vol. 4, No. 5. pp. 348-356.
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abstract = "Objectives: The aim of this study was to assess temporal trends and factors associated with digoxin use at discharge among patients admitted with heart failure (HF). Background: Digoxin has class IIa recommendations for treating HF with reduced ejection fraction (HFrEF) in the United States. Digoxin use, temporal trends, and clinical characteristics of HF patients in current clinical practice in the United States have not been well studied. Methods: An observational analysis of 255,901 patients hospitalized with HF (117,761 with HFrEF and 138,140 with preserved EF [HFpEF]) from 398 hospitals participating in the Get With The Guidelines-HF registry between January 2005 and June 2014 was conducted to assess the temporal trends and factors associated with digoxin use. Results: Among 117,761 HFrEF patients, only 19.7{\%} received digoxin at discharge. Digoxin prescriptions decreased from 33.1{\%} in 2005 to 10.7{\%} in 2014 (ptrend < 0.0001). Factors associated with digoxin use in HFrEF included atrial fibrillation (AF) (odds ratio [OR]: 2.14; 95{\%} confidence intervals [CI]: 2.02 to 2.28), history of implantable cardioverter defibrillator use (OR: 1.39; 95{\%} CI: 1.32 to 1.46), chronic obstructive pulmonary disease (OR: 1.13, 95{\%} CI: 1.08 to 1.18), diabetes mellitus (OR: 1.10, 95{\%} CI: 1.06 to 1.14), younger age (OR: 0.96, 95{\%} CI: 0.95 to 0.97), lower blood pressure (OR: 0.96, 95{\%} CI: 0.96 to 0.97), and having no history of renal insufficiency (OR: 0.91, 95{\%} CI: 0.85 to 0.97). Use of digoxin in patients with HFpEF (n = 138,140) without AF was 9.8{\%} in 2005, which decreased to 2.2{\%} in 2014 (ptrend < 0.0001). Conclusions: One in 5 HFrEF patients received digoxin at discharge, with a significant downward temporal trend in use over the study period. Use of digoxin in HFpEF patients without AF was very low and decreased over the study period.",
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AU - Patel, Nish

AU - Ju, Christine

AU - Macon, Conrad

AU - Thadani, Udho

AU - Schulte, Phillip

AU - Hernandez, Adrian F.

AU - Bhatt, Deepak L.

AU - Butler, Javed

AU - Yancy, Clyde W.

AU - Fonarow, Gregg C.

PY - 2016/5/1

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N2 - Objectives: The aim of this study was to assess temporal trends and factors associated with digoxin use at discharge among patients admitted with heart failure (HF). Background: Digoxin has class IIa recommendations for treating HF with reduced ejection fraction (HFrEF) in the United States. Digoxin use, temporal trends, and clinical characteristics of HF patients in current clinical practice in the United States have not been well studied. Methods: An observational analysis of 255,901 patients hospitalized with HF (117,761 with HFrEF and 138,140 with preserved EF [HFpEF]) from 398 hospitals participating in the Get With The Guidelines-HF registry between January 2005 and June 2014 was conducted to assess the temporal trends and factors associated with digoxin use. Results: Among 117,761 HFrEF patients, only 19.7% received digoxin at discharge. Digoxin prescriptions decreased from 33.1% in 2005 to 10.7% in 2014 (ptrend < 0.0001). Factors associated with digoxin use in HFrEF included atrial fibrillation (AF) (odds ratio [OR]: 2.14; 95% confidence intervals [CI]: 2.02 to 2.28), history of implantable cardioverter defibrillator use (OR: 1.39; 95% CI: 1.32 to 1.46), chronic obstructive pulmonary disease (OR: 1.13, 95% CI: 1.08 to 1.18), diabetes mellitus (OR: 1.10, 95% CI: 1.06 to 1.14), younger age (OR: 0.96, 95% CI: 0.95 to 0.97), lower blood pressure (OR: 0.96, 95% CI: 0.96 to 0.97), and having no history of renal insufficiency (OR: 0.91, 95% CI: 0.85 to 0.97). Use of digoxin in patients with HFpEF (n = 138,140) without AF was 9.8% in 2005, which decreased to 2.2% in 2014 (ptrend < 0.0001). Conclusions: One in 5 HFrEF patients received digoxin at discharge, with a significant downward temporal trend in use over the study period. Use of digoxin in HFpEF patients without AF was very low and decreased over the study period.

AB - Objectives: The aim of this study was to assess temporal trends and factors associated with digoxin use at discharge among patients admitted with heart failure (HF). Background: Digoxin has class IIa recommendations for treating HF with reduced ejection fraction (HFrEF) in the United States. Digoxin use, temporal trends, and clinical characteristics of HF patients in current clinical practice in the United States have not been well studied. Methods: An observational analysis of 255,901 patients hospitalized with HF (117,761 with HFrEF and 138,140 with preserved EF [HFpEF]) from 398 hospitals participating in the Get With The Guidelines-HF registry between January 2005 and June 2014 was conducted to assess the temporal trends and factors associated with digoxin use. Results: Among 117,761 HFrEF patients, only 19.7% received digoxin at discharge. Digoxin prescriptions decreased from 33.1% in 2005 to 10.7% in 2014 (ptrend < 0.0001). Factors associated with digoxin use in HFrEF included atrial fibrillation (AF) (odds ratio [OR]: 2.14; 95% confidence intervals [CI]: 2.02 to 2.28), history of implantable cardioverter defibrillator use (OR: 1.39; 95% CI: 1.32 to 1.46), chronic obstructive pulmonary disease (OR: 1.13, 95% CI: 1.08 to 1.18), diabetes mellitus (OR: 1.10, 95% CI: 1.06 to 1.14), younger age (OR: 0.96, 95% CI: 0.95 to 0.97), lower blood pressure (OR: 0.96, 95% CI: 0.96 to 0.97), and having no history of renal insufficiency (OR: 0.91, 95% CI: 0.85 to 0.97). Use of digoxin in patients with HFpEF (n = 138,140) without AF was 9.8% in 2005, which decreased to 2.2% in 2014 (ptrend < 0.0001). Conclusions: One in 5 HFrEF patients received digoxin at discharge, with a significant downward temporal trend in use over the study period. Use of digoxin in HFpEF patients without AF was very low and decreased over the study period.

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