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Internal and Emergency Medicine

, Volume 9, Issue 7, pp 759–765 | Cite as

The previous use of digoxin does not worsen early outcome of acute coronary syndromes: an analysis of the ARIAM Registry

  • Juan Carlos Garcia-RubiraEmail author
  • Manuel Calvo-Taracido
  • Francisca Francisco-Aparicio
  • Manuel Almendro-Delia
  • Alejandro Recio-Mayoral
  • Antonio Reina Toral
  • Oscar Aramburu-Bodas
  • Pastora Gallego García de Vinuesa
  • José Maria Cruz Fernández
  • Angel Garcia Alcántara
  • Rafael Hidalgo-Urbano
IM - ORIGINAL

Abstract

The aim of the study was to determine the influence of the previous use of digoxin on the hospital mortality and complications of patients admitted because of acute coronary syndrome (ACS). We analyzed the data of patients included in the ARIAM-Andalucia Registry, which involves 49 hospitals in Andalucia, Spain, from 2007 to 2012. Patients on digoxin treatment prior to their admission because of ACS constituted the digoxin group (DG), and were compared with the group of patients not on digoxin. Logistic regression and propensity score matching were used to analyze the differences. We included 20,331 patients, of whom 244 (1.2 %) were on digoxin. DG patients were older (73.1 vs 63.7 years old), more often women, and had more diabetes, hypertension, previous myocardial infarction, heart failure, stroke, atrial fibrillation, peripheral vascular disease, obstructive pulmonary disease or kidney disease. On univariate analysis, DG patients had significantly higher hospital mortality (13.5 vs 5.3 % P < 0.001), and more cardiogenic shock, but less ventricular fibrillation, and no differences in atrioventricular block, stroke or reinfarction. After the multivariate analysis, DG had no significant influence on hospital prognosis [odds ratio (OR) 1.21, 95 % confidence interval 0.79–1.86]. The analysis of a propensity-matched cohort of 464 patients (232 DG and 232 NoDG) did not find differences in hospital mortality (13.4 vs 13.4 %) nor other complications. In our cohort of ACS patients, the previous treatment with digoxin was not associated with an increase in dysrhythmic complications nor was an independent predictor of mortality during hospitalization.

Keywords

Acute coronary syndrome Atrial fibrillation Dysrhythmias Digoxin Heart failure Myocardial infarction 

List of abbreviations

ACS

Acute coronary syndrome

AF

Atrial fibrillation

CI

Confidence interval

DG

Patients on digoxin treatment previously to their admission

MI

Myocardial infarction

NoDG

Patients not on digoxin treatment previously to their admission

NoSTE

Acute coronary syndrome without ST elevation

OR

Odds ratio

STE

Acute coronary syndrome with ST elevation

Notes

Acknowledgments

We are indebt with the Health Council of the Junta de Andalucia and the “Plan Integral de Cardiopatías en Andalucía” (PICA) for the support of the registry. We are also grateful to the general secretariat of the virtual platform ARIAM-Andalucia, and to the Software Company Coresoft Clínico (http://www.coresoft.es). Without their help, this work would not have been possible.

Conflict of interest

None.

Supplementary material

11739_2013_1032_MOESM1_ESM.doc (39 kb)
Supplementary material 1 (DOC 39 kb)

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Copyright information

© SIMI 2013

Authors and Affiliations

  • Juan Carlos Garcia-Rubira
    • 1
    • 5
    Email author
  • Manuel Calvo-Taracido
    • 1
  • Francisca Francisco-Aparicio
    • 1
  • Manuel Almendro-Delia
    • 1
  • Alejandro Recio-Mayoral
    • 1
  • Antonio Reina Toral
    • 2
  • Oscar Aramburu-Bodas
    • 3
  • Pastora Gallego García de Vinuesa
    • 1
  • José Maria Cruz Fernández
    • 1
  • Angel Garcia Alcántara
    • 4
  • Rafael Hidalgo-Urbano
    • 1
  1. 1.Cardiology DepartmentVirgen Macarena University HospitalSevilleSpain
  2. 2.Intensive Care UnitVirgen de las Nieves HospitalGranadaSpain
  3. 3.Internal Medicine DepartmentVirgen Macarena University HospitalSevilleSpain
  4. 4.Intensive Care UnitVirgen de la Victoria HospitalMálagaSpain
  5. 5.Unidad CoronariaHospital Virgen MacarenaSevilleSpain

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