Outcomes of digoxin vs. beta blocker in atrial fibrillation: report from ESC–EHRA EORP AF Long-Term General Registry - Archive ouverte HAL
Article Dans Une Revue European Heart Journal - Cardiovascular Pharmacotherapy Année : 2021

Outcomes of digoxin vs. beta blocker in atrial fibrillation: report from ESC–EHRA EORP AF Long-Term General Registry

Michele Brignole (1) , Francesco Pentimalli , Pietro Palmisano , Maurizio Landolina (2) , Fabio Quartieri , Eraldo Occhetta , Leonardo Calò (3) , Giuseppe Mascia , Lluis Mont (4) , Kevin Vernooy (5) , Vincent van Dijk , Cor Allaart , Laurent Fauchier (6, 7) , Maurizio Gasparini , Gianfranco Parati (8) , Davide Soranna , Michiel Rienstra (9) , Isabelle van Gelder (9) , Jean-Michel Halimi (6, 10) , Philippe Gatault (6) , Hélène Longuet (6) , Christelle Barbet (6) , Annabelle Goumard , Juliette Gueguen (11) , Nicolas Goin (12, 13, 14) , Bénédicte Sautenet (15, 10) , Julien Herbert (6) , Arnaud Bisson (6) , Wern Yew Ding , Giuseppe Boriani (16) , Francisco Marin (17) , Carina Blomström-Lundqvist (18) , Tatjana Potpara (19) , Gregory Lip (20, 21)
1 UNIMI - Università degli Studi di Milano = University of Milan
2 Fondazione IRCCS Policlinico San Matteo [Pavia]
3 Ospedale Policlinico Casilino - Policlinico Casilino
4 Cardiology Department, Thorax Clinic Institute, Hospital Cliınic, Institut d'Investigacions Biomèdiques [Barcelona]
5 Radboud University Medical Center [Nijmegen]
6 CHU Trousseau [Tours]
7 EES - Éducation Éthique Santé EA 7505
8 EAS - European Atherosclerosis Society [Göteborg, Sweden]
9 UMCG - University Medical Center Groningen [Groningen]
10 Service de néphrologie et immunologie clinique [CHRU Tours]
11 CESP - Centre de recherche en épidémiologie et santé des populations
12 Hôpital Bretonneau
13 Hôpital Gatien de Clocheville [Tours]
14 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
15 SPHERE - MethodS in Patients-centered outcomes and HEalth ResEarch
16 UNIMORE - Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia
17 Universidad de Murcia
18 Uppsala University
19 University of Belgrade [Belgrade]
20 University of Liverpool
21 AAU - Aalborg University [Denmark]
Michele Brignole
Università degli Studi di Milano = University of Milan
Francesco Pentimalli
Pietro Palmisano
Maurizio Landolina
  • Fonction : Auteur
Fondazione IRCCS Policlinico San Matteo [Pavia]
Fabio Quartieri
  • Fonction : Auteur
Eraldo Occhetta
  • Fonction : Auteur
Leonardo Calò
Policlinico Casilino
Giuseppe Mascia
Lluis Mont
  • Fonction : Auteur
Cardiology Department, Thorax Clinic Institute, Hospital Cliınic, Institut d'Investigacions Biomèdiques [Barcelona]
Kevin Vernooy
Radboud University Medical Center [Nijmegen]
Vincent van Dijk
  • Fonction : Auteur
Cor Allaart
  • Fonction : Auteur
Laurent Fauchier
CHU Trousseau [Tours]
Éducation Éthique Santé EA 7505
Maurizio Gasparini
Gianfranco Parati
European Atherosclerosis Society [Göteborg, Sweden]
Davide Soranna
  • Fonction : Auteur
Michiel Rienstra
University Medical Center Groningen [Groningen]
Isabelle van Gelder
  • Fonction : Auteur
University Medical Center Groningen [Groningen]
Jean-Michel Halimi
CHU Trousseau [Tours]
Service de néphrologie et immunologie clinique [CHRU Tours]
Philippe Gatault
CHU Trousseau [Tours]
Hélène Longuet
  • Fonction : Auteur
CHU Trousseau [Tours]
Christelle Barbet
  • Fonction : Auteur
CHU Trousseau [Tours]
Annabelle Goumard
  • Fonction : Auteur
Juliette Gueguen
  • Fonction : Auteur
Centre de recherche en épidémiologie et santé des populations
Nicolas Goin
  • Fonction : Auteur
Hôpital Bretonneau
Hôpital Gatien de Clocheville [Tours]
Centre Hospitalier Régional Universitaire de Tours
Bénédicte Sautenet
MethodS in Patients-centered outcomes and HEalth ResEarch
Service de néphrologie et immunologie clinique [CHRU Tours]
CV
Julien Herbert
CHU Trousseau [Tours]
Arnaud Bisson
CHU Trousseau [Tours]
Wern Yew Ding
Giuseppe Boriani
Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia
Francisco Marin
  • Fonction : Auteur
Universidad de Murcia
Carina Blomström-Lundqvist
Uppsala University
Tatjana Potpara
University of Belgrade [Belgrade]
Gregory Lip
University of Liverpool
Aalborg University [Denmark]

Résumé

Abstract Aims The safety of digoxin therapy in atrial fibrillation (AF) remains ill-defined. We aimed to evaluate the effects of digoxin over beta-blocker therapy in AF. Methods and results Patients with AF who were treated with either digoxin or a beta blocker from the ESC–EHRA EORP AF (European Society of Cardiology–European Heart Rhythm Association EURObservational Research Programme Atrial Fibrillation) General Long-Term Registry were included. Outcomes of interest were all-cause mortality, cardiovascular (CV) mortality, non-CV mortality, quality of life, and number of patients with unplanned hospitalizations. Of 6377 patients, 549 (8.6%) were treated with digoxin. Over 24 months, there were 550 (8.6%) all-cause mortality events and 1304 (23.6%) patients with unplanned emergency hospitalizations. Compared to beta blocker, digoxin therapy was associated with increased all-cause mortality [hazard ratio (HR) 1.90 (95% confidence interval, CI, 1.48–2.44)], CV mortality [HR 2.18 (95% CI 1.47–3.21)], and non-CV mortality [HR 1.68 (95% CI 1.02–2.75)] with reduced quality of life [health utility score 0.555 (±0.406) vs. 0.705 (±0.346), P < 0.001] but no differences in emergency hospitalizations [HR 1.00 (95% CI 0.56–1.80)] or AF-related hospitalizations [HR 0.95 (95% CI 0.60–1.52)]. On multivariable analysis, there were no differences in any of the outcomes between both groups, after accounting for potential confounders. Similar results were obtained in the subgroups of patients with permanent AF and coexisting heart failure. There were no differences in outcomes between AF patients receiving digoxin with and without chronic kidney disease. Conclusion Poor outcomes related to the use of digoxin over beta-blocker therapy in terms of excess mortality and reduced quality of life are associated with the presence of other risk factors rather than digoxin per se. The choice of digoxin or beta-blocker therapy had no influence on the incidence of unplanned hospitalizations.

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Sciences de l'Homme et Société

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https://hal.science/hal-03656028

Soumis le : samedi 30 avril 2022-17:39:27

Dernière modification le : lundi 8 juillet 2024-17:23:42

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Dates et versions

hal-03656028 , version 1 (30-04-2022)

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Citer

Michele Brignole, Francesco Pentimalli, Pietro Palmisano, Maurizio Landolina, Fabio Quartieri, et al.. Outcomes of digoxin vs. beta blocker in atrial fibrillation: report from ESC–EHRA EORP AF Long-Term General Registry. European Heart Journal - Cardiovascular Pharmacotherapy, 2021, 6 (10), pp.2594-2603. ⟨10.1093/ehjcvp/pvab076⟩. ⟨hal-03656028⟩

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