Questionable utility of digoxin in left-ventricular assist device recipients: A multicenter, retrospective analysis


Autoři: Mustafa M. Ahmed aff001;  Henri Roukoz aff002;  Jaimin R. Trivedi aff003;  Adarsh Bhan aff004;  Ashwin Ravichandran aff005;  Rahul Dhawan aff006;  Jennifer Cowger aff007;  Geetha Bhat aff004;  Emma J. Birks aff008;  Mark S. Slaughter aff003;  Rakesh Gopinathannair aff009
Působiště autorů: Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States of America aff001;  Cardiovascular Division, Electrophysiology Section, University of Minnesota, Minneapolis, MN, United States of America aff002;  Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY, United States of America aff003;  Heart Institute, Advocate Christ Medical Center, Oak Lawn, IL, United States of America aff004;  St. Vincent Heart Center of Indiana, Indianapolis, IN, United States of America aff005;  University of Nebraska, Omaha, Nebraska, United States of America aff006;  Henry Ford Hospital, Detroit, Michigan, United States of America aff007;  Division of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky, United States of America aff008;  Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, Kansas, United States of America aff009
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225628

Souhrn

Background

While clinical experience with left ventricular assist devices (LVAD) continues to grow and evolve, little is known regarding the ongoing use of certain medications in this population. We sought to evaluate the utility of digoxin in LVAD recipients and its association with outcomes.

Methods

A total of 505 patients who underwent continuous-flow LVAD implantation at 5 centers from 2007–2015 were included. Patients were divided into 4 groups: not on digoxin at any time (ND; n = 257), received digoxin pre implant (PreD; n = 144), received digoxin pre and post implant (ContD; n = 55), and received digoxin only post implant (PostD; n = 49). Survival and all-cause readmission were compared between the 4 groups.

Results

There was no difference in survival at 1 year nor at 3 years between groups (ND = 88%, 66%, respectively; PreD = 85%, 66%; ContD = 86%, 57%; PostD = 90%, 51%; p = 0.7). Readmission per 100 days also was not different between groups (ND = 0.5, PreD = 0.6, ContD = 0.5, PostD = 0.7; p = 0.1).

Conclusions

In this large, multicenter cohort, use of digoxin was not associated with any significant benefit in regard to mortality or hospitalization in patients supported with a continuous-flow LVAD. Importantly, its discontinuation post implant did not worsen all-cause hospitalization or survival.

Klíčová slova:

Arrhythmia – Atrial fibrillation – Diuretics – Gastrointestinal analysis – Heart failure – Medical devices and equipment – Medical implants


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 11