Digoxin use and lower risk of 30‐day all‐cause readmission in older patients with heart failure and reduced ejection fraction receiving β‐blockers

摘要

Background Digoxin use has been associated with a lower risk of 30‐day all‐cause admission and readmission in patients with heart failure and reduced ejection fraction (HFrEF). Hypothesis Digoxin use will be associated with improved outcomes in patients with HFrEF receiving β‐blockers. Methods Of the 3076 hospitalized Medicare beneficiaries with HFrEF (EF Results 30‐day all‐cause readmission occurred in 15% and 27% of those receiving and not receiving digoxin, respectively (hazard ratio [HR]: 0.51, 95% confidence interval [CI]: 0.31‐0.83, P =?0.007). This beneficial association persisted during 4?years of follow‐up (HR: 0.72, 95% CI: 0.57‐0.92, P =?0.008). Digoxin use was also associated with a lower risk of the combined endpoint of all‐cause readmission or all‐cause mortality at 30?days (HR: 0.54, 95% CI: 0.34‐0.86, P =?0.009) and at 4?years (HR: 0.76, 95% CI: 0.61‐0.96, P =?0.020). Conclusions In hospitalized patients with HFrEF receiving β‐blockers, digoxin use was associated with a lower risk of 30‐day all‐cause readmission but not mortality, which persisted during longer follow‐up.