Digoxin use is associated with increased platelet and endothelial cell activation in patients with nonvalvular atrial fibrillation

Chirinos, Julio A.; Castrellon, Aurelio; Zambrano, Juan P.; Jiménez, Joaquín J.; Jy, Wenche; Horstman, Lawrence L.; Willens, Howard J.; Castellanos, Agustín; Myerburg, Robert J.; Ahn, Yeon S.

doi:10.1016/j.hrthm.2005.01.016

Cited by 56 publications

(35 citation statements)

References 22 publications

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“…Mechanisms through which digoxin increases mortality are not yet clarified [33]. The suggested mechanisms include clinical relevant bradycardia, atrio-ventricular block and ventricular arrhythmias [12]; these arrhythmias may be facilitated by coexistence of electrolyte imbalances (i.e.…”

Section: Discussionmentioning

confidence: 99%

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Digoxin treatment is associated with increased total and cardiovascular mortality in anticoagulated patients with atrial fibrillation

Pastori

Farcomeni

Bucci

et al. 2015

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

“…hypokalemia, hypomagnesemia and hypercalcemia) and/or unrecognized atrio-ventricular accessory pathways [34]. Other putative mechanisms include increased endothelial and platelet activation in AF patients [33], but not in healthy volunteers [35] and activation of baroreceptor function and neuroendocrine system [36,37].…”

Section: Discussionmentioning

confidence: 99%

Digoxin treatment is associated with increased total and cardiovascular mortality in anticoagulated patients with atrial fibrillation

Pastori

Farcomeni

Bucci

et al. 2015

International Journal of Cardiology

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“…26 -28 The trend toward an increase in hospitalization for unstable angina may be related to reported, but not well-studied, effects of digoxin on platelet and endothelial cell activation. 29 …”

Section: Clinical Implications: Role Of Digoxin In Diastolic Hfmentioning

confidence: 99%

Effects of Digoxin on Morbidity and Mortality in Diastolic Heart Failure

et al. 2006

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Background-About half of the 5 million heart failure patients in the United States have diastolic heart failure (clinical heart failure with normal or near-normal ejection fraction). Except for candesartan, no drugs have been tested in randomized clinical trials in these patients. Although digoxin was tested in an appreciable number of diastolic heart failure patients in the Digitalis Investigation Group ancillary trial, detailed findings from this important study have not previously been published. Methods and Results-Ambulatory chronic heart failure patients (nϭ988) with normal sinus rhythm and ejection fraction Ͼ45% (median, 53%) from the United States and Canada (1991 to 1993) were randomly assigned to digoxin (nϭ492) or placebo (nϭ496). During follow-up with a mean length of 37 months, 102 patients (21%) in the digoxin group and 119 patients (24%) in the placebo group (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.63 to 1.07; Pϭ0.136) experienced the primary combined outcome of heart failure hospitalization or heart failure mortality. Digoxin had no effect on all-cause or cause-specific mortality or on all-cause or cardiovascular hospitalization. Use of digoxin was associated with a trend toward a reduction in hospitalizations resulting from worsening heart failure (HR, 0.79; 95% CI, 0.59 to 1.04; Pϭ0.094) but also a trend toward an increase in hospitalizations for unstable angina (HR, 1.37; 95% CI, 0.99 to 1.91; Pϭ0.061). Conclusions-In ambulatory patients with chronic mild to moderate diastolic heart failure and normal sinus rhythm receiving angiotensin-converting enzyme inhibitor and diuretics, digoxin had no effect on natural history end points such as mortality and all-cause or cardiovascular hospitalizations.

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“…Digoxin does not improve survival rates in patients with CHF and sinus rhythm and is potentially dangerous in women. Digoxin use in AF is associated with increased levels of endothelial and platelet activation [22]. However, the clinical relevance of this fi nding is not yet clear.…”

Section: Digitalismentioning

confidence: 95%

Atrial fibrillation in heart failure: Current treatment of patients with remodeled atria

Neuberger

Reil²,

Adam³

et al. 2008

Curr Heart Fail Rep

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Atrial fibrillation (AF) and chronic heart failure (CHF) can be caused by each other, and therefore constitute a vicious circle. The prevalence of both conditions is about 1% in industrialized countries and increases with age. Although mortality is increased in heart failure, the additional prognostic relevance of AF in these patients is less clear. AF in patients with CHF can worsen heart failure symptoms, cause complications (eg, stroke), and is difficult to treat. Thus, prevention of AF entirely is an important goal. This review summarizes recent data concerning prognostic relevance, treatment, and means of primary and secondary prevention of AF in patients with CHF.

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Digoxin use is associated with increased platelet and endothelial cell activation in patients with nonvalvular atrial fibrillation

Cited by 56 publications

References 22 publications

Digoxin treatment is associated with increased total and cardiovascular mortality in anticoagulated patients with atrial fibrillation

Digoxin treatment is associated with increased total and cardiovascular mortality in anticoagulated patients with atrial fibrillation

Effects of Digoxin on Morbidity and Mortality in Diastolic Heart Failure

Atrial fibrillation in heart failure: Current treatment of patients with remodeled atria

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