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

Ding, Wern Yew; Boriani, Giuseppe; Marin, Francisco; Blomström-Lundqvist, Carina; Potpara, Tatjana S; Fauchier, Laurent; Lip, Gregory Y H; null, null; Boriani (Chair), G; Lip, G Y H; Tavazzi, L; Maggioni, A P; Dan, G-A; Potpara, T; Nabauer, M; Marin, F; Kalarus, Z; Fauchier, L; Goda, A; Mairesse, G; Shalganov, T; Antoniades, L; Taborsky, M; Riahi, S; Muda, P; Bolao, I García; Piot, O; Nabauer, M; Etsadashvili, K; Simantirakis, E; Haim, M; Azhari, A; Najafian, J; Santini, M; Mirrakhimov, E; Kulzida, K a; Erglis, A; Poposka, L; Burg, M; Crijns, H; Erküner, Ö; Atar, D; Lenarczyk, R; Oliveira, M Martins; Shah, D; Dan, G-A; Serdechnaya, E; Potpara, T; Diker, E; Lip, G Y H; Lane, D; Zëra, E; Ekmekçiu, U; Paparisto, V; Tase, M; Gjergo, H; Dragoti, J; Goda, A; Ciutea, M; Ahadi, N; el Husseini, Z; Raepers, M; Leroy, J; Haushan, P; Jourdan, A; Lepiece, C; Desteghe, L; Vijgen, J; Koopman, P; Van Genechten, G; Heidbuchel, H; Boussy, T; De Coninck, M; Van Eeckhoutte, H; Bouckaert, N; Friart, A; Boreux, J; Arend, C; Evrard, P; Stefan, L; Hoffer, E; Herzet, J; Massoz, M; Celentano, C; Sprynger, M; Pierard, L; Melon, P; Van Hauwaert, B; Kuppens, C; Faes, D; Van Lier, D; Van Dorpe, A; Gerardy, A; Deceuninck, O; Xhaet, O; Dormal, F; Ballant, E; Blommaert, D; Yakova, D; Hristov, M; Yncheva, T; Stancheva, N; Tisheva, S; Tokmakova, M; Nikolov, F; Gencheva, D; Shalganov, T; Kunev, B; Stoyanov, M; Marchov, D; Gelev, V; Traykov, V; Kisheva, A; Tsvyatkov, H; Shtereva, R; Bakalska-Georgieva, S; Slavcheva, S; Yotov, Y; Kubíčková, M; Marni Joensen, A; Gammelmark, A; Rasmussen, L Hvilsted; Dinesen, P; Riahi, S; Venø, S Krogh; Sorensen, B; Korsgaard, A; Andersen, K; Hellum, C Fragtrup; Svenningsen, A; Nyvad, O; Wiggers, P; May, O; Aarup, A; Graversen, B; Jensen, L; Andersen, M; Svejgaard, M; Vester, S; Hansen, S; Lynggaard, V; Ciudad, M; Vettus, R; Muda, P; Maestre, A; Castaño, S; Cheggour, S; Poulard, J; Mouquet, V; Leparrée, S; Bouet, J; Taieb, J; Doucy, A; Duquenne, H; Furber, A; Dupuis, J; Rautureau, J; Font, M; Damiano, P; Lacrimini, M; Abalea, J; Boismal, S; Menez, T; Mansourati, J; Range, G; Gorka, H; Laure, C; Vassalière, C; Elbaz, N; Lellouche, N; Djouadi, K; Roubille, F; Dietz, D; Davy, J; Granier, M; Winum, P; Leperchois-Jacquey, C; Kassim, H; Marijon, E; Le Heuzey, J; Fedida, J; Maupain, C; Himbert, C; Gandjbakhch, E; Hidden-Lucet, F; Duthoit, G; Badenco, N; Chastre, T; Waintraub, X; Oudihat, M; Lacoste, J; Stephan, C; Bader, H; Delarche, N; Giry, L; Arnaud, D; Lopez, C; Boury, F; Brunello, I; Lefèvre, M; Mingam, R; Haissaguerre, M; Le Bidan, M; Pavin, D; Le Moal, V; Leclercq, C; Piot, O; Beitar, T; Martel, I; Schmid, A; Sadki, N; Romeyer-Bouchard, C; Da Costa, A; Arnault, I; Boyer, M; Piat, C; Fauchier, L; Lozance, N; Nastevska, S; Doneva, A; Fortomaroska Milevska, B; Sheshoski, B; Petroska, K; Taneska, N; Bakrecheski, N; Lazarovska, K; Jovevska, S; Ristovski, V; Antovski, A; Lazarova, E; Kotlar, Irina; Taleski, Jane; Poposka, Lidija; Kedev, Sashko; Zlatanovik, N; Jordanova, S; Bajraktarova Proseva, T; Doncovska, S; Maisuradze, D; Esakia, A; Sagirashvili, E; Lartsuliani, K; Natelashvili, N; Gumberidze, N; Gvenetadze, R; Etsadashvili, K; Gotonelia, N; Kuridze, N; Papiashvili, G; Menabde, I; Glöggler, S; Napp, A; Lebherz, C; Romero, H; Schmitz, K; Berger, M; Zink, M; Köster, S; Sachse, J; Vonderhagen, E; Soiron, G; Mischke, K; Reith, R; Schneider, M; Rieker, W; Boscher, D; Taschareck, A; Beer, A; Oster, D; Ritter, O; Adamczewski, J; Walter, S; Frommhold, A; Luckner, E; Richter, J; Schellner, M; Landgraf, S; Bartholome, S; Naumann, R; Schoeler, J; Westermeier, D; William, F; Wilhelm, K; Maerkl, M; Oekinghaus, R; Denart, M; Kriete, M; Tebbe, U; Scheibner, T; Gruber, M; Gerlach, A; Beckendorf, C; Anneken, L; Arnold, M; Lengerer, S; Bal, Z; Uecker, C; Förtsch, H; Fechner, S; Mages, V; Martens, E; Methe, H; Schmidt, T; Schaeffer, B; Hoffmann, B; Moser, J; Heitmann, K; Willems, S; Willems, S; Klaus, C; Lange, I; Durak, M; Esen, E; Mibach, F; Mibach, H; Utech, A; Gabelmann, M; Stumm, R; Ländle, V; Gartner, C; Goerg, C; Kaul, N; Messer, S; Burkhardt, D; Sander, C; Orthen, R; Kaes, S; Baumer, A; Dodos, F; Barth, A; Schaeffer, G; Gaertner, J; Winkler, J; Fahrig, A; Aring, J; Wenzel, I; Steiner, S; Kliesch, A; Kratz, E; Winter, K; Schneider, P; Haag, A; Mutscher, I; Bosch, R; Taggeselle, J; Meixner, S; Schnabel, A; Shamalla, A; Hötz, H; Korinth, A; Rheinert, C; Mehltretter, G; Schön, B; Schön, N; Starflinger, A; Englmann, E; Baytok, G; Laschinger, T; Ritscher, G; Gerth, A; Dechering, D; Eckardt, L; Kuhlmann, M; Proskynitopoulos, N; Brunn, J; Foth, K; Axthelm, C; Hohensee, H; Eberhard, K; Turbanisch, S; Hassler, N; Koestler, A; Stenzel, G; Kschiwan, D; Schwefer, M; Neiner, S; Hettwer, S; Haeussler-Schuchardt, M; Degenhardt, R; Sennhenn, S; Steiner, S; Brendel, M; Stoehr, A; Widjaja, W; Loehndorf, S; Logemann, A; Hoskamp, J; Grundt, J; Block, M; Ulrych, R; Reithmeier, A; Panagopoulos, V; Martignani, C; Bernucci, D; Fantecchi, E; Diemberger, I; Ziacchi, M; Biffi, M; Cimaglia, P; Frisoni, J; Boriani, G; Giannini, I; Boni, S; Fumagalli, S; Pupo, S; Di Chiara, A; Mirone, P; Fantecchi, E; Boriani, G; Pesce, F; Zoccali, C; Malavasi, V L; Mussagaliyeva, A; Ahyt, B; Salihova, Z; Koshum-Bayeva, K; Kerimkulova, A; Bairamukova, A; Mirrakhimov, E; Lurina, B; Zuzans, R; Jegere, S; Mintale, I; Kupics, K; Jubele, K; Erglis, A; Kalejs, O; Vanhear, K; Burg, M; Cachia, M; Abela, E; Warwicker, S; Tabone, T; Xuereb, R; Asanovic, D; Drakalovic, D; Vukmirovic, M; Pavlovic, N; Music, L; Bulatovic, N; Boskovic, A; Uiterwaal, H; Bijsterveld, N; De Groot, J; Neefs, J; van den Berg, N; Piersma, F; Wilde, A; Hagens, V; Van Es, J; Van Opstal, J; Van Rennes, B; Verheij, H; Breukers, W; Tjeerdsma, G; Nijmeijer, R; Wegink, D; Binnema, R; Said, S; Erküner, Ö; Philippens, S; van Doorn, W; Crijns, H; Szili-Torok, T; Bhagwandien, R; Janse, P; Muskens, A; van Eck, M; Gevers, R; van der Ven, N; Duygun, A; Rahel, B; Meeder, J; Vold, A; Hansen, C Holst; Engset, I; Atar, D; Dyduch-Fejklowicz, B; 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Cretu, D; Patrascu, N; Stoicescu, C; Udroiu, C; Bicescu, G; Vintila, V; Vinereanu, D; Cinteza, M; Rimbas, R; Grecu, M; Cozma, A; Boros, F; Ille, M; Tica, O; Tor, R; Corina, A; Jeewooth, A; Maria, B; Georgiana, C; Natalia, C; Alin, D; Dinu-Andrei, D; Livia, M; Daniela, R; Larisa, R; Umaar, S; Tamara, T; Ioachim Popescu, M; Nistor, D; Sus, I; Coborosanu, O; Alina-Ramona, N; Dan, R; Petrescu, L; Ionescu, G; Popescu, I; Vacarescu, C; Goanta, E; Mangea, M; Ionac, A; Mornos, C; Cozma, D; Pescariu, S; Solodovnicova, E; Soldatova, I; Shutova, J; Tjuleneva, L; Zubova, T; Uskov, V; Obukhov, D; Rusanova, G; Soldatova, I; Isakova, N; Odinsova, S; Arhipova, T; Kazakevich, E; Serdechnaya, E; Zavyalova, O; Novikova, T; Riabaia, I; Zhigalov, S; Drozdova, E; Luchkina, I; Monogarova, Y; Hegya, D; Rodionova, L; Rodionova, L; Nevzorova, V; Soldatova, I; Lusanova, O; Arandjelovic, A; Toncev, D; Vukmirovic, L; Radisavljevic, M; Milanov, M; Sekularac, N; Zdravkovic, M; Hinic, S; Dimkovic, S; Acimovic, T; Saric, J; Radovanovic, S; Kocijancic, A; Obrenovic-Kircanski, B; Kalimanovska Ostric, D; Simic, D; Jovanovic, I; Petrovic, I; Polovina, M; Vukicevic, M; Tomasevic, M; Mujovic, N; Radivojevic, N; Petrovic, O; Aleksandric, S; Kovacevic, V; Mijatovic, Z; Ivanovic, B; Tesic, M; Potpara, T; Ristic, A; Vujisic-Tesic, B; Nedeljkovic, M; Karadzic, A; Uscumlic, A; Prodanovic, M; Zlatar, M; Asanin, M; Bisenic, B; Vasic, V; Popovic, Z; Djikic, D; Sipic, M; Peric, V; Dejanovic, B; Milosevic, N; Backovic, S; Stevanovic, A; Andric, A; Pencic, B; Pavlovic-Kleut, M; Celic, V; Pavlovic, M; Petrovic, M; Vuleta, M; Petrovic, N; Simovic, S; Savovic, Z; Milanov, S; Davidovic, G; Iric-Cupic, V; Djordjevic, D; Damjanovic, M; Zdravkovic, S; Topic, V; Stanojevic, D; Randjelovic, M; Jankovic-Tomasevic, R; Atanaskovic, V; Antic, S; Pavlovic, M; Simonovic, D; Stojanovic, M; Stojanovic, S; Mitic, V; Ilic, V; Petrovic, D; Deljanin Ilic, M; Ilic, S; Stoickov, V; Markovic, S; Mijatovic, A; Tanasic, D; Petrovic, D; Radakovic, G; 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Наслов:	Outcomes of digoxin vs. beta blocker in atrial fibrillation: report from ESC–EHRA EORP AF Long-Term General Registry
Authors:	Ding, Wern Yew Boriani, Giuseppe Marin, Francisco Blomström-Lundqvist, Carina Potpara, Tatjana S Fauchier, Laurent Lip, Gregory Y H null, null Boriani (Chair), G Lip, G Y H Tavazzi, L Maggioni, A P Dan, G-A Potpara, T Nabauer, M Marin, F Kalarus, Z Fauchier, L Goda, A Mairesse, G Shalganov, T Antoniades, L Taborsky, M Riahi, S Muda, P Bolao, I García Piot, O Nabauer, M Etsadashvili, K Simantirakis, E Haim, M Azhari, A Najafian, J Santini, M Mirrakhimov, E Kulzida, K a Erglis, A Poposka, L Burg, M Crijns, H Erküner, Ö Atar, D Lenarczyk, R Oliveira, M Martins Shah, D Dan, G-A Serdechnaya, E Potpara, T Diker, E Lip, G Y H Lane, D Zëra, E Ekmekçiu, U Paparisto, V Tase, M Gjergo, H Dragoti, J Goda, A Ciutea, M Ahadi, N el Husseini, Z Raepers, M Leroy, J Haushan, P Jourdan, A Lepiece, C Desteghe, L Vijgen, J Koopman, P Van Genechten, G Heidbuchel, H Boussy, T De Coninck, M Van Eeckhoutte, H Bouckaert, N Friart, A Boreux, J Arend, C Evrard, P Stefan, L Hoffer, E Herzet, J Massoz, M Celentano, C Sprynger, M Pierard, L Melon, P Van Hauwaert, B Kuppens, C Faes, D Van Lier, D Van Dorpe, A Gerardy, A Deceuninck, O Xhaet, O Dormal, F Ballant, E Blommaert, D Yakova, D Hristov, M Yncheva, T Stancheva, N Tisheva, S Tokmakova, M Nikolov, F Gencheva, D Shalganov, T Kunev, B Stoyanov, M Marchov, D Gelev, V Traykov, V Kisheva, A Tsvyatkov, H Shtereva, R Bakalska-Georgieva, S Slavcheva, S Yotov, Y Kubíčková, M Marni Joensen, A Gammelmark, A Rasmussen, L Hvilsted Dinesen, P Riahi, S Venø, S Krogh Sorensen, B Korsgaard, A Andersen, K Hellum, C Fragtrup Svenningsen, A Nyvad, O Wiggers, P May, O Aarup, A Graversen, B Jensen, L Andersen, M Svejgaard, M Vester, S Hansen, S Lynggaard, V Ciudad, M Vettus, R Muda, P Maestre, A Castaño, S Cheggour, S Poulard, J Mouquet, V Leparrée, S Bouet, J Taieb, J Doucy, A Duquenne, H Furber, A Dupuis, J Rautureau, J Font, M Damiano, P Lacrimini, M Abalea, J Boismal, S Menez, T Mansourati, J Range, G Gorka, H Laure, C Vassalière, C Elbaz, N Lellouche, N Djouadi, K Roubille, F Dietz, D Davy, J Granier, M Winum, P Leperchois-Jacquey, C Kassim, H Marijon, E Le Heuzey, J Fedida, J Maupain, C Himbert, C Gandjbakhch, E Hidden-Lucet, F Duthoit, G Badenco, N Chastre, T Waintraub, X Oudihat, M Lacoste, J Stephan, C Bader, H Delarche, N Giry, L Arnaud, D Lopez, C Boury, F Brunello, I Lefèvre, M Mingam, R Haissaguerre, M Le Bidan, M Pavin, D Le Moal, V Leclercq, C Piot, O Beitar, T Martel, I Schmid, A Sadki, N Romeyer-Bouchard, C Da Costa, A Arnault, I Boyer, M Piat, C Fauchier, L Lozance, N Nastevska, S Doneva, A Fortomaroska Milevska, B Sheshoski, B Petroska, K Taneska, N Bakrecheski, N Lazarovska, K Jovevska, S Ristovski, V Antovski, A Lazarova, E Kotlar, Irina Taleski, Jane Poposka, Lidija Kedev, Sashko Zlatanovik, N Jordanova, S Bajraktarova Proseva, T Doncovska, S Maisuradze, D Esakia, A Sagirashvili, E Lartsuliani, K Natelashvili, N Gumberidze, N Gvenetadze, R Etsadashvili, K Gotonelia, N Kuridze, N Papiashvili, G Menabde, I 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Keywords:	Atrial fibrillation Digoxin Beta blocker Rate control Mortality Hospitalizations Quality of life Permanent AF Heart failure CKD EORP-AF Registry
Issue Date:	19-окт-2021
Publisher:	Oxford University Press (OUP)
Journal:	European Heart Journal - Cardiovascular Pharmacotherapy
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.
URI:	http://hdl.handle.net/20.500.12188/33326
DOI:	10.1093/ehjcvp/pvab076
Appears in Collections:	Faculty of Medicine: Journal Articles

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