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

Mustafa M. Ahmed, Henri Roukoz, Jaimin R. Trivedi, Adarsh Bhan, Ashwin Ravichandran, Rahul Dhawan, Jennifer Cowger, Geetha Bhat, Emma J. Birks, Mark S. Slaughter, Rakesh Gopinathannair

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Abstract

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.

Original languageEnglish (US)
Article numbere0225628
JournalPloS one
Volume14
Issue number11
DOIs
StatePublished - Jan 1 2019

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All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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Ahmed, M. M., Roukoz, H., Trivedi, J. R., Bhan, A., Ravichandran, A., Dhawan, R., Cowger, J., Bhat, G., Birks, E. J., Slaughter, M. S., & Gopinathannair, R. (2019). Questionable utility of digoxin in left-ventricular assist device recipients: A multicenter, retrospective analysis. PloS one, 14(11), [e0225628]. https://doi.org/10.1371/journal.pone.0225628