Impact of digoxin on all-cause mortality and re-hospitalizations in acute heart failure patients

Background and Objectives: The use of digoxin in acute heart failure (AHF) is not without controversy. The aim of this study was to examine the impact of digoxin therapy on all-cause mortality and re-hospitalizations for heart failure (HF) at 3 months and 12 months in AHF patients in the Arabian Gulf stratified by left ventricular ejection fraction (EF). Methods: Data were analyzed from 4577 consecutive patients admitted to 47 hospitals in seven Middle Eastern countries with AHF from February to November, 2012. Analyses were performed using univariate and multivariate statistical techniques. Results: The overall mean age of the cohort was 59 ± 15 years, and 63% (n = 2887) were males. At hospital discharge, digoxin was prescribed to 25% (n = 1156) of the patients. Nearly 59% (n = 2683) of the patients had HF with reduced EF (HFr EF) ( 0.05). Digoxin use was also not associated with any benefits regarding re-hospitalization for HF at either 3 months or at 12 months in any type of HF (all P > 0.05). Conclusions: Digoxin was associated with lower cumulative all-cause mortality at both 3-month and 12-month follow-ups in AHF patients with reduced EF in the Arabian Gulf. However, digoxin use did not offer any survival advantages in those with HFmr EF and HFp EF after either 3 months or 12 months. Digoxin use was also not associated with any benefits toward re-hospitalizations for HF at a 3-month or 12-month follow-up in AHF patients.