{"id":"517c30f9f9ae","type":"article","url":"https://hartvaat.nl/2018/03/13/digoxine-en-mortaliteit-bij-patienten-met-atriumfibrilleren/","title":"Digoxine en mortaliteit bij patiënten met atriumfibrilleren","title_en":"Digoxin and Mortality in Patients With Atrial Fibrillation.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["apotheker","cardioloog"],"tags":["acuut-hartfalen"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2017.12.060","source_url":"https://doi.org/10.1016/j.jacc.2017.12.060","authors":["Renato D Lopes","Roberto Rordorf","Gaetano M De Ferrari","Sergio Leonardi","Laine Thomas","Daniel M Wojdyla","Peter Ridefelt","John H Lawrence","Raffaele De Caterina","Dragos Vinereanu","Michael Hanna","Greg Flaker","Sana M Al-Khatib","Stefan H Hohnloser","John H Alexander","Christopher B Granger","Lars Wallentin"],"significance":6,"published":"2018-03-13","source_date":"2018-03-13","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-bij-ouderen/","https://hartvaat.nl/kennis/antistolling/doacs-overzicht/"],"congress":"","summary_en":"This study explored the association between digoxin use and mortality in AF patients, contributing to the long-standing controversy about digoxin safety in the contemporary treatment of atrial fibrillation.","created":"2026-07-03T10:27:12Z","updated":"2026-07-03T18:38:37Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar de relatie tussen digoxinegebruik en mortaliteit bij AF-patiënten. Het debat over de veiligheid van digoxine bij AF blijft actueel.","abstract_original":"BACKGROUND: Digoxin is widely used in patients with atrial fibrillation (AF). OBJECTIVES: The goal of this paper was to explore whether digoxin use was independently associated with increased mortality in patients with AF and if the association was modified by heart failure and/or serum digoxin concentration. METHODS: The association between digoxin use and mortality was assessed in 17,897 patients by using a propensity score-adjusted analysis and in new digoxin users during the trial versus propensity score-matched control participants. The authors investigated the independent association between serum digoxin concentration and mortality after multivariable adjustment. RESULTS: At baseline, 5,824 (32.5%) patients were receiving digoxin. Baseline digoxin use was not associated with an increased risk of death (adjusted hazard ratio [HR]: 1.09; 95% confidence interval [CI]: 0.96 to 1.23; p = 0.19). However, patients with a serum digoxin concentration ≥1.2 ng/ml had a 56% increased hazard of mortality (adjusted HR: 1.56; 95% CI: 1.20 to 2.04) compared with those not on digoxin. When analyzed as a continuous variable, serum digoxin concentration was associated with a 19% higher adjusted hazard of death for each 0.5-ng/ml increase (p = 0.0010); these results were similar for patients with and without heart failure. Compared with propensity score-matched control participants, the risk of death (adjusted HR: 1.78; 95% CI: 1.37 to 2.31) and sudden death (adjusted HR: 2.14; 95% CI: 1.11 to 4.12) was significantly higher in new digoxin users. CONCLUSIONS: In patients with AF taking digoxin, the risk of death was independently related to serum digoxin concentration and was highest in patients with concentrations ≥1.2 ng/ml. Initiating digoxin was independently associated with higher mortality in patients with AF, regardless of heart failure."}