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Effect of Digoxin Use Among Medicaid Enrollees With Atrial Fibrillation.

Title: Effect of Digoxin Use Among Medicaid Enrollees With Atrial Fibrillation.
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Name(s): Adedinsewo, Demilade, author
Xu, Junjun, author
Agasthi, Pradyumna, author
Oderinde, Adesoji, author
Adekeye, Oluwatoyosi, author
Sachdeva, Rajesh, author
Rust, George, author
Onwuanyi, Anekwe, author
Type of Resource: text
Genre: Journal Article
Text
Date Issued: 2017-05-01
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: Recently published analysis of contemporary atrial fibrillation (AF) cohorts showed an association between digoxin and increased mortality and hospitalizations; however, other studies have demonstrated conflicting results. Many AF cohort studies did not or were unable to examine racial differences. Our goal was to examine risk factors for hospitalizations and mortality with digoxin use in a diverse real-world AF patient population and evaluate racial differences. We performed a retrospective cohort analysis of claims data for Medicaid beneficiaries, aged 18 to 64 years, with incident diagnosis of AF in 2008 with follow-up until December 31, 2009. We created Kaplan-Meier curves and constructed multivariable Cox proportional hazard models for mortality and hospitalization. We identified 11 297 patients with an incident diagnosis of AF in 2008, of those, 1401 (12.4%) were on digoxin. Kaplan-Meier analysis demonstrated an increased risk of hospitalization with digoxin use overall and within race and heart failure groups. In adjusted models, digoxin was associated with an increased risk of hospitalization (adjusted hazard ratio, 1.54; 95% confidence interval, 1.39-1.70) and mortality (adjusted hazard ratio, 1.50; 95% confidence interval, 1.05-2.13). Overall, blacks had a higher risk of hospitalization but similar mortality when compared with whites regardless of digoxin use. We found no significant interaction between race and digoxin use for mortality (=0.4437) and hospitalization (=0.7122). Our study demonstrates an overall increased risk of hospitalizations and mortality with digoxin use but no racial/ethnic differences in outcomes were observed. Further studies including minority populations are needed to critically evaluate these associations.
Identifier: FSU_pmch_28500174 (IID), 10.1161/CIRCEP.116.004573 (DOI), PMC5522586 (PMCID), 28500174 (RID), 28500174 (EID), CIRCEP.116.004573 (PII)
Keywords: Medicaid, Atrial fibrillation, Digoxin, Heart failure, Hospitalization
Grant Number: K18 HS022444, P20 MD006881, U54 MD007588
Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522586.
Subject(s): Administrative Claims, Healthcare
Adolescent
Adult
African Americans
Anti-Arrhythmia Agents/adverse effects
Anti-Arrhythmia Agents/therapeutic use
Atrial Fibrillation/diagnosis
Atrial Fibrillation/drug therapy
Atrial Fibrillation/ethnology
Atrial Fibrillation/mortality
Chi-Square Distribution
Digoxin/adverse effects
Digoxin/therapeutic use
Disease Progression
Drug Utilization Review
European Continental Ancestry Group
Female
Heart Failure/diagnosis
Heart Failure/drug therapy
Heart Failure/ethnology
Heart Failure/mortality
Hospitalization
Humans
Incidence
Kaplan-Meier Estimate
Male
Medicaid
Middle Aged
Propensity Score
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
United States
Young Adult
Persistent Link to This Record: http://purl.flvc.org/fsu/fd/FSU_pmch_28500174
Owner Institution: FSU
Is Part Of: Circulation. Arrhythmia and electrophysiology.
1941-3084
Issue: iss. 5, vol. 10

Choose the citation style.
Adedinsewo, D., Xu, J., Agasthi, P., Oderinde, A., Adekeye, O., Sachdeva, R., … Onwuanyi, A. (2017). Effect of Digoxin Use Among Medicaid Enrollees With Atrial Fibrillation. Circulation. Arrhythmia And Electrophysiology. Retrieved from http://purl.flvc.org/fsu/fd/FSU_pmch_28500174