title: Mortality and morbidity of heart failure treated with digoxin. A propensity-matched study.
abstract: BACKGROUND
  The role of digoxin in the prognosis of patients with heart failure (HF) remains unclear.
  
  
  OBJECTIVE
  To evaluate the relationship of commencing treatment with digoxin (CTDig) with the mortality and the morbidity of patients with HF.
  
  
  METHODS
  Prospective study over 8 years on 4467 patients with HF. Main outcomes were all-cause and cardiovascular mortality, hospitalisations and visits. We analyse the independent relationship of CTDig, with the mortality and the morbidity, stratifying patients for cardiovascular comorbidity, after propensity score-matching for potential confounders (1421 patients who CTDig vs. another 1421 patients non-exposed to digoxin).
  
  
  RESULTS
  During a median follow up of 46.1 months, 1872 patients (65.9%) died, and 2203 (77.5%) were hospitalised. CTDig was associated with a lower all-cause mortality (HR = 0.90 [95% CI, 0.84-0.97]), and cardiovascular mortality (HR = 0.87 [0.81-0.96]), hospitalisation (HR = 0.91 [0.86-0.97]), 30-day readmission for HF (HR = 0.88 [0.79-0.95]), and visits (HR = 0.94 [0.90-0.98]) (p < 0.001 in all cases), after adjustment for the propensity to take digoxin, other medications, and other potential confounders. These effects of digoxin were independent of gender, or type of HF (systolic or non-systolic).
  
  
  CONCLUSIONS
  The data suggest that therapy with digoxin is associated with an improved mortality and morbidity of HF, including women and patients with non-systolic HF.
authors.affiliation: Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Andrey
authors.forename: S
authors.initials: S
authors.lastname: Romero
authors.forename: A
authors.initials: A
authors.lastname: García-Egido
authors.forename: M A
authors.initials: MA
authors.lastname: Escobar
authors.forename: R
authors.initials: R
authors.lastname: Corzo
authors.forename: G
authors.initials: G
authors.lastname: Garcia-Dominguez
authors.forename: V
authors.initials: V
authors.lastname: Lechuga
authors.forename: F
authors.initials: F
authors.lastname: Gómez
mesh_terms: D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004077:Digoxin / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D057216:Propensity Score; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents; D004077:Digoxin