title: Inappropriate use of digoxin in patients presenting with digoxin toxicity.
abstract: BACKGROUND
  Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of elderly patients hospitalized for digoxin toxicity.
  
  
  METHODS
  The study included 99 consecutive patients hospitalized for digoxin toxicity. The other study criteria for the inappropriate use of digoxin was regarded if participants having depressed left ventricular systolic function (ejection fraction < 45%) who were not on optimal medical therapy including beta-blocker and angiotensin-converting-enzyme inhibitor therapy or if participants having permanent AF who were not on optimal beta-blocker therapy.
  
  
  RESULTS
  Appropriate digoxin usage was confirmed in 33 of patients in spite of its narrow therapeutic index. A total of 16 of 99 patients died, with a mean follow-up time of 22.1 ± 10.3 months.
  
  
  CONCLUSIONS
  Contrary to popular belief, the rate of inappropriate digoxin usage remains high. On account of its narrow therapeutic index and toxicity, digoxin should be used more carefully according to the current evidence and guidelines.
authors: Department of Cardiology, Sivas Numune State Hospital, Rahmi Gunay Street, Sivas 58000, Turkey.
authors: Mustafa Adem
authors: MA
authors: Tatlisu
authors: Department of Cardiology, Kocaeli Derince Education and Research Hospital, İbni Sina Street, Kocaeli 41900, Turkey.
authors: Kazim Serhan
authors: KS
authors: Ozcan
authors: Department of Cardiology, Dr.Siyami Ersek Cardiovascular Surgery Education and Research Hospital, Tıbbiye street, Istanbul, 34668, Turkey.
authors: Baris
authors: B
authors: Gungor
authors: Department of Cardiology, Dr.Siyami Ersek Cardiovascular Surgery Education and Research Hospital, Tıbbiye street, Istanbul, 34668, Turkey.
authors: Ahmet
authors: A
authors: Zengin
authors: Department of Cardiology, Dr.Siyami Ersek Cardiovascular Surgery Education and Research Hospital, Tıbbiye street, Istanbul, 34668, Turkey.
authors: Mehmet Baran
authors: MB
authors: Karatas
authors: Department of Cardiology, Istanbul Medipol University, Kosuyolu, Istanbul, 34718, Turkey.
authors: Zekeriya
authors: Z
authors: Nurkalem
keywords: Digoxin; Ejection fraction; Indications; Toxicity