TY - JOUR
T1 - Temporal Trends of Digoxin Use in Patients Hospitalized With Heart Failure. Analysis From the American Heart Association Get With The Guidelines-Heart Failure Registry.
AU - Patel, Nish
AU - Ju, Christine
AU - Macon, Conrad
AU - Thadani, Udho
AU - Schulte, Phillip J.
AU - Hernandez, Adrian F.
AU - Bhatt, Deepak L.
AU - Butler, Javed
AU - Yancy, Clyde W.
AU - Fonarow, Gregg C.
N1 - Funding Information:
Dr. Hernandez has received honoraria from Amgen, Gilead, Janssen, Merck & Co., Inc., and Novartis; and research funding from Amgen, AstraZeneca, BMS, GlaxoSmithKline, Janssen, Novartis, and Portola; Dr. Bhatt is a member of the Advisory Board for Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, and Regado Biosciences; a member of the Board of Directors for Boston VA Research Institute, Society of Cardiovascular Patient Care; is the Past Chair of the American Heart Association Get With The Guidelines Steering Committee; a member of the Data Monitoring Committees for Duke Clinical Research Institute, Harvard Clinical Research Institute, Mayo Clinic, and the Population Health Research Institute; has received honoraria from the American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org ), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), Harvard Clinical Research Institute (clinical trial steering committee), HMP Communications (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), Population Health Research Institute (clinical trial steering committee), Slack Publications (Chief Medical Editor, Cardiology Today’s Intervention), and WebMD (CME steering committees); Other: Clinical Cardiology (Deputy Editor); has received research funding from Amarin, AstraZeneca, Bristol-Myers Squibb, Eisai, Ethicon, Forest Laboratories, Ischemix, Medtronic, Pfizer, Roche, Sanofi Aventis, and The Medicines Company; has been a site co-investigator for Biotronik, St. Jude Medical; has been a trustee for American College of Cardiology; and has performed unfunded research for FlowCo, PLx Pharma, and Takeda; Dr. Butler has received honoraria from Travena Inc., and Takeda and research funding from the National Institute of Health; Dr. Yancy has received research funding from the Patient Centered Outcomes Research Institute; Dr. Fonarow has received honoraria from Amgen, Boston Scientific, Johnson & Johnson, The Medicines Company, Medtronic, Novartis, and Takeda; has received research funding from Gambro, Medtronic, the National Heart, Lung, and Blood Institute, and the National Institute of Health/ National Institute of Allergy and Infectious Diseases; and has been a consultant for Medtronic, Novartis, Amgen, and Janssen. The other authors have reported that they have no relationships relevant to the discussion of this paper to disclose.
Funding Information:
The Get With The Guidelines–Heart Failure (GWTG-HF) program is provided by the American Heart Association. GWTG-HF is sponsored, in part, by Amgen Cardiovascular and has been funded in the past through support from Medtronic, GlaxoSmithKline, Ortho-McNeil, and the American Heart Association Pharmaceutical Roundtable.
Publisher Copyright:
© 2016 American College of Cardiology Foundation.
PY - 2016/5/1
Y1 - 2016/5/1
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.
KW - Digoxin
KW - GWTG-HF
KW - Heart failure
KW - Trends
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U2 - 10.1016/j.jchf.2015.12.003
DO - 10.1016/j.jchf.2015.12.003
M3 - Article
C2 - 26874392
AN - SCOPUS:84964744574
VL - 4
SP - 348
EP - 356
JO - JACC: Heart Failure
JF - JACC: Heart Failure
SN - 2213-1779
IS - 5
ER -