title: Digoxin use may increase the relative risk of acute pancreatitis: A population-based case-control study in Taiwan.
abstract: OBJECTIVE
  The goal of this study was to evaluate the association between digoxin use and acute pancreatitis in Taiwan.
  
  
  METHODS
  Utilizing the database of the Taiwan National Health Insurance Program, this case-control study consisted of 6116 subjects aged 20-84years with a first-attack of acute pancreatitis since 2000 to 2011 as the cases and 24,464 randomly selected subjects without acute pancreatitis as the controls. Both cases and controls were matched by sex, age and index year of diagnosing acute pancreatitis. The absence of digoxin prescription was defined as "never use". Active use of digoxin was defined as subjects who at least received 1 prescription for digoxin within 7days before the date of diagnosing acute pancreatitis. Non-active use of digoxin was defined as subjects who did not receive a prescription within 7days but at least received 1 prescription for digoxin ≥8days before the date of diagnosing acute pancreatitis. The odds ratio (OR) and 95% confidence interval (CI) were measured to evaluate the association between digoxin use and acute pancreatitis by a multivariable unconditional logistic regression model.
  
  
  RESULTS
  After adjusting for potential confounding factors, the adjusted OR of acute pancreatitis was 5.29 for subjects with active use of digoxin (95% CI 3.61, 7.73), when compared with subjects with never use of digoxin. The adjusted OR of acute pancreatitis decreased to 1.04 for subjects with non-active use of digoxin (95% CI 0.89, 1.21), but no statistical significance.
  
  
  CONCLUSIONS
  These data indicate that only persons actively using digoxin may have the high relative odds of acute pancreatitis. Further research or case report is warranted to evaluate the pathophysiological basis underlying the relationship between digoxin use and acute pancreatitis.
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Lai
authors.affiliation: Department of Public Health, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan; Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan. Electronic address: kuanfuliao@yahoo.com.tw.
authors.forename: Kuan-Fu
authors.initials: KF
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D004077:Digoxin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D011159:Population Surveillance; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000889:Anti-Arrhythmia Agents; D004077:Digoxin
keywords: Acute pancreatitis; Chronic renal disease; Digoxin