Latest & greatest articles for digoxin

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Top results for digoxin

1. Meta-Analysis of Effects of Digoxin on Survival in Patients with Atrial Fibrillation or Heart Failure: An Update

Meta-Analysis of Effects of Digoxin on Survival in Patients with Atrial Fibrillation or Heart Failure: An Update In 2015, 3 independent meta-analyses raised concerns about digoxin therapy being associated with an increased mortality risk in patients with atrial fibrillation (AF) and with heart failure (HF). Although several other studies have been published since then fostering these safety issues, the most recent 2016 European guidelines for AF still recommend this therapy as a class I (...) indication. We performed an updated systematic review and random-effect meta-analysis on publications up to March 2018 reporting data on digoxin associated mortality in subjects with AF or HF. Based on the adjusted survival data of all identified 37 trials comprising a total of 825,061 patients, digoxin use was associated with an increased relative risk of all-cause mortality (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.05 to 1.29, p <0.01). Treatment with digoxin was associated

2019 EvidenceUpdates

2. Digoxin

Digoxin Top results for digoxin - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 (...) or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for digoxin The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you

2018 Trip Latest and Greatest

3. Digoxin and Mortality in Patients With Atrial Fibrillation

Digoxin and Mortality in Patients With Atrial Fibrillation Digoxin is widely used in patients with atrial fibrillation (AF).The goal of this paper was to explore whether digoxin use was independently associated with increased mortality in patients with AF and if the association was modified by heart failure and/or serum digoxin concentration.The association between digoxin use and mortality was assessed in 17,897 patients by using a propensity score-adjusted analysis and in new digoxin users (...) during the trial versus propensity score-matched control participants. The authors investigated the independent association between serum digoxin concentration and mortality after multivariable adjustment.At baseline, 5,824 (32.5%) patients were receiving digoxin. Baseline digoxin use was not associated with an increased risk of death (adjusted hazard ratio [HR]: 1.09; 95% confidence interval [CI]: 0.96 to 1.23; p = 0.19). However, patients with a serum digoxin concentration ≥1.2 ng/ml had a 56

2018 EvidenceUpdates

4. Colored floaters as a manifestation of digoxin toxicity (PubMed)

Colored floaters as a manifestation of digoxin toxicity Since its report in one patient more than 70 years ago, digitalis-induced colored muscae volitantes have not surfaced again in the literature. We report here a case of digoxin induced colored floaters.An 89-year-old man on 0.25 mg digoxin daily developed visual hallucinations and colored floaters. He had floaters in the past but now they were in various colors including yellow, green, blue and red, though predominantly in yellow (...) . These "weirdly" shaped little particles wiggled around as if in a viscous solution and casted shadows in his vision. He also saw geometric shapes, spirals, and cross hatch patterns of various colors that moved and undulated, especially on wallpaper. Ophthalmic examination revealed reduced visual acuity, poor color vision especially in his left eye, along with central depression on Amsler grid and Humphrey visual field in his left eye. Discontinuation of digoxin resulted in complete resolution of his visual

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2018 American journal of ophthalmology case reports

5. Digoxin overdose

Digoxin overdose Digoxin overdose - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Digoxin overdose Last reviewed: February 2019 Last updated: March 2018 Summary Can be acute or chronic, intentional, or accidental. Typically presents with components of GI, constitutional, and/or cardiovascular symptoms. Diagnosis is based on symptoms and laboratory data. At therapeutic digoxin doses (0.6-1.2 nanomol/L [0.5 to 0.9 (...) nanograms/mL]), the ECG typically shows PR-interval prolongation and a scooped ST segment. In overdose, ECG also shows signs of increased automaticity (PVCs), AV nodal blockade, and slowed ventricular response. Treatment includes digoxin-specific antibody fragments and supportive care. Lidocaine and phenytoin can be used for cardiac dysrhythmias when antibody fragments are unavailable. There are no long-term complications of poisoning in patients treated appropriately for chronic digoxin toxicity

2018 BMJ Best Practice

8. Digoxin use in patients with atrial fibrillation and adverse cardiovascular outcomes: a retrospective analysis of the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in (PubMed)

Digoxin use in patients with atrial fibrillation and adverse cardiovascular outcomes: a retrospective analysis of the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Digoxin is a widely used drug for ventricular rate control in patients with atrial fibrillation (AF), despite a scarcity of randomised trial data. We studied the use and outcomes of digoxin in patients in the Rivaroxaban Once Daily Oral Direct (...) Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF).For this retrospective analysis, we included and classified patients from ROCKET AF on the basis of digoxin use at baseline and during the study. Patients in ROCKET AF were recruited from 45 countries and had AF and risk factors putting them at moderate-to-high risk of stroke, with or without heart failure. We used Cox proportional hazards regression models adjusted

2015 Lancet

9. Cohort study: Digoxin initiation is associated with lower risk of all-cause readmission after hospitalisation for heart failure

Cohort study: Digoxin initiation is associated with lower risk of all-cause readmission after hospitalisation for heart failure Digoxin initiation is associated with lower risk of all-cause readmission after hospitalisation for heart failure | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using (...) your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Digoxin initiation is associated with lower risk of all-cause readmission after hospitalisation for heart failure Article Text Prognosis Cohort

2014 Evidence-Based Medicine (Requires free registration)

10. Lack of evidence of increased mortality among patients with atrial fibrillation taking digoxin: findings from post hoc propensity-matched analysis of the AFFIRM trial (PubMed)

Lack of evidence of increased mortality among patients with atrial fibrillation taking digoxin: findings from post hoc propensity-matched analysis of the AFFIRM trial Digoxin is recommended for long-term rate control in paroxysmal, persistent, and permanent atrial fibrillation (AF). While some analyses suggest an association of digoxin with a higher mortality in AF, the intrinsic nature of this association has not been examined in propensity-matched cohorts, which is the objective (...) of the current study.In Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM), 4060 patients with paroxysmal and persistent AF were randomized to rate (n = 2027) vs. rhythm (n = 2033) control strategies. Of these, 1377 received digoxin as initial therapy and 1329 received no digoxin at baseline. Propensity scores for digoxin use were estimated for each of these 2706 patients and used to assemble a cohort of 878 pairs of patients receiving and not receiving digoxin, who were balanced on 59

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2013 EvidenceUpdates Controlled trial quality: uncertain

11. Digoxin use and the risk of breast cancer in women (PubMed)

Digoxin use and the risk of breast cancer in women Digoxin resembles estrogen chemically and may have estrogenic effect. We hypothesized that digoxin use might increase breast cancer incidence and examined if use might be associated with risk of breast cancer, categorized by estrogen receptor (ER) status. To determine if being under care for heart disease biased the findings, rate ratios in users of angina drugs were similarly evaluated as a control exposure group.Women using digoxin and angina (...) drugs were identified in the nationwide Danish Prescription Database, available between 1995 and 2008. Incident breast cancers were identified in the Danish Cancer Registry and further classifying by ER status. Relative risks (RR) were compared to nonusers using age- and period-adjusted incidence rate ratios.Two thousand one hundred forty-four of 104,648 women using digoxin developed breast cancer. Current digoxin users were at increased risk of breast cancer (RR, 1.39; 95% CI, 1.32 to 1.46

2011 EvidenceUpdates

12. Are calcium channel blockers superior to digoxin for controlling the ventricular rate in patients with recent onset atrial fibrillation?

Are calcium channel blockers superior to digoxin for controlling the ventricular rate in patients with recent onset atrial fibrillation? BestBets: Are calcium channel blockers superior to digoxin for controlling the ventricular rate in patients with recent onset atrial fibrillation? Are calcium channel blockers superior to digoxin for controlling the ventricular rate in patients with recent onset atrial fibrillation? Report By: Richard Parris - Locum Consultant Emergency Medicine Search checked (...) by Simon Clarke - Consultant Emergency Medicine Institution: Emergency Department Royal Bolton Hospital Date Submitted: 9th September 2004 Date Completed: 17th December 2009 Last Modified: 18th December 2009 Status: Green (complete) Three Part Question In a stable patient with [acute atrial fibrillation], is [treatment superior] with [calcium channel blockers or digoxin]? Clinical Scenario A 57 year old woman attends the Emergency Department with palpitations of uncertain duration. A diagnosis

2010 BestBETS

13. Intravenous diltiazem is superior to intravenous amiodarone or digoxin for achieving ventricular rate control in patients with acute uncomplicated atrial fibrillation (PubMed)

Intravenous diltiazem is superior to intravenous amiodarone or digoxin for achieving ventricular rate control in patients with acute uncomplicated atrial fibrillation To compare the clinical efficacy of intravenous diltiazem, digoxin, and amiodarone for acute ventricular rate (VR) control in patients with acute symptomatic atrial fibrillation (AF) necessitating hospitalization.Randomized control trial.Acute emergency medical admission unit in a regional teaching hospital in Hong Kong.One (...) hundred fifty adult patients with acute AF and rapid VR (>120 bpm).Patients were randomly assigned in 1:1:1 ratio to receive intravenous diltiazem, digoxin, or amiodarone for VR control.The primary end point was sustained VR control (<90 bpm) within 24 hours; the secondary end points included AF symptom improvement and length of hospitalization. At 24 hours, VR control was achieved in 119 of 150 patients (79%). The time to VR control was significantly shorter among patients in the diltiazem group (log

2009 EvidenceUpdates Controlled trial quality: uncertain

14. Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department?

Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department? BestBets: Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department? Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department? Report By: Martin Hossack - Medical Student Search checked by Rick Body - Specialist Registrar Institution: Manchester (...) Royal Infirmary Date Submitted: 7th July 2008 Date Completed: 9th January 2009 Last Modified: 14th November 2008 Status: Green (complete) Three Part Question In [patients presenting to the Emergency Department with atrial fibrillation requiring rate limitation] are [beta blockers superior in efficacy and safety to digoxin] in [achieving rate control]? Clinical Scenario A 60 year old man comes to the Emergency Department with symptoms of palpitations. ECG recording confirms atrial fibrillation

2009 BestBETS

15. Digoxin and reduction of heart failure hospitalization in chronic systolic and diastolic heart failure (PubMed)

Digoxin and reduction of heart failure hospitalization in chronic systolic and diastolic heart failure In the Digitalis Investigation Group trial, digoxin-associated decrease in the combined end point of heart failure (HF) hospitalization or HF mortality was significant in systolic but not in diastolic HF. To assess whether this apparent disparity could be explained by differences in baseline characteristics and sample size, we used propensity score matching to assemble a cohort of 916 pairs (...) of patients with systolic and diastolic HF who were balanced in all measured baseline covariates. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of the effect of digoxin on outcomes separately in systolic and diastolic HF, at 2 years (protocol prespecified), and at the end of 3.2 years of median follow-up. HF hospitalization or HF mortality occurred in 28% and 32% of patients with systolic HF (HR digoxin vs placebo 0.85, 95% CI 0.67 to 1.08, p = 0.188) and 20% and 25% in those

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2009 EvidenceUpdates Controlled trial quality: uncertain

16. Digoxin increased risk of death in women, but not men, with heart failure

Digoxin increased risk of death in women, but not men, with heart failure Digoxin increased risk of death in women, but not men, with heart failure | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username (...) * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Digoxin increased risk of death in women, but not men, with heart failure Article Text Treatment Digoxin increased risk of death in women, but not men, with heart failure Free Elizabeth Rideout , RN, PhD Statistics from Altmetric.com Rathore SS

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2004 Evidence-Based Nursing

17. Association of serum digoxin concentration and outcomes in patients with heart failure. (PubMed)

Association of serum digoxin concentration and outcomes in patients with heart failure. The Digitalis Investigation Group (DIG) trial reported that digoxin provided no overall mortality benefit and only a modest reduction in hospitalizations among patients with heart failure and depressed left ventricular systolic function. The clinical outcomes associated with digoxin therapy at different serum concentrations in the DIG trial have not been assessed.To assess variations in serum digoxin (...) concentration (SDC) and their association with mortality and hospitalization in patients with heart failure.Post hoc analysis of the randomized, double-blinded, placebo-controlled DIG trial, conducted from August 1991 to December 1995, with the main analysis restricted to men with a left ventricular ejection fraction of 45% or less (n = 3782). Patients randomly assigned to receive digoxin were divided into 3 groups based on SDC at 1 month (0.5-0.8 ng/mL, n = 572; 0.9-1.1 ng/mL, n = 322; and > or =1.2 ng/mL

2003 JAMA Controlled trial quality: predicted high

18. Sex-based differences in the effect of digoxin for the treatment of heart failure. (PubMed)

Sex-based differences in the effect of digoxin for the treatment of heart failure. The Digitalis Investigation Group trial reported that treatment with digoxin did not decrease overall mortality among patients with heart failure and depressed left ventricular systolic function, although it did reduce hospitalizations slightly. Even though the epidemiologic features, causes, and prognosis of heart failure vary between men and women, sex-based differences in the effect of digoxin were (...) not evaluated.We conducted a post hoc subgroup analysis to assess whether there were sex-based differences in the effect of digoxin therapy among the 6800 patients in the Digitalis Investigation Group study. The presence of an interaction between sex and digoxin therapy with respect to the primary end point of death from any cause was evaluated with the use of Mantel-Haenszel tests of heterogeneity and a multivariable Cox proportional-hazards model, adjusted for demographic and clinical variables.There

2002 NEJM Controlled trial quality: uncertain

19. Analysis of the use of digoxin immune fab for the treatment of non-life-threatening digoxin toxicity

Analysis of the use of digoxin immune fab for the treatment of non-life-threatening digoxin toxicity Analysis of the use of digoxin immune fab for the treatment of non-life-threatening digoxin toxicity Analysis of the use of digoxin immune fab for the treatment of non-life-threatening digoxin toxicity DiDomenico R J, Walton S M, Sanoski C A, Bauman J L Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains (...) a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology This study evaluated the use of digoxin immune Fab (FAB) in the treatment of patients with non-life-threatening digoxin toxicity. The use of FAB was compared to standard therapy. Standard therapy consisted of supportive care aimed at correcting electrolyte abnormalities, treating arrhythmias and correcting any precipitating

2000 NHS Economic Evaluation Database.

20. Anti-digoxin Fab fragments in cardiotoxicity induced by ingestion of yellow oleander: a randomised controlled trial. (PubMed)

Anti-digoxin Fab fragments in cardiotoxicity induced by ingestion of yellow oleander: a randomised controlled trial. Severe cardiac glycoside cardiotoxicity after ingestion of yellow oleander seeds is an important problem in rural areas of Sri Lanka. Currently, patients must be transferred to the capital for temporary cardiac pacing. We did a randomised controlled trial to investigate whether anti-digoxin Fab could reverse serious oleander-induced arrhythmias.After a preliminary dose-finding (...) study, 66 patients who presented to hospital with a serious cardiac arrhythmia were randomised to receive either 1200 mg of anti-digoxin Fab or a saline placebo. A 12-lead electrocardiogram, 3 min rhythm strip, and blood sample for measurement of electrolytes and cardiac glycosides were taken before treatment and at 12 timepoints thereafter.34 patients received anti-digoxin Fab and 32 received placebo. The presenting arrhythmia had resolved completely after 2 h in 15 antibody-treated patients

2000 Lancet Controlled trial quality: uncertain