Digoxin and short term mortality after acute STEMI

Results from the MAGIC trial

Mohamed Metawee, Richard Charnigo, Gustavo Morales, Yousef Darrat, Vincent Sorrell, Luigi Di Biase, Andrea Natale, Brian Delisle, Claude S. Elayi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background The safety of digoxin has been a subject of debate for decades, most recently among patients with atrial fibrillation (AF). Digoxin has been used during the acute phase of ST elevation myocardial infarction (STEMI) complicated with AF or heart failure. Data about digoxin in this setting are scarce. Hypothesis We hypothesize that digoxin maybe associated with increased mortality when used during the acute phase of ST segment myocardial infarction. Methods We investigated the association between digoxin and mortality in patients enrolled in the MAGnesium In Coronaries (MAGIC) study, which evaluated the efficacy of early magnesium administration in STEMI. Multiple Cox proportional hazards models were examined to assess the aforementioned association after correction for clinical characteristics and comorbidities. Results After excluding 639 (10.3%) patients for missing data, we analyzed the remaining 5574 patients. There were 852 (15.3%) deaths during the one month follow-up and 170 (3.0%) patients on digoxin concomitantly, among which 42 patients (24.7%) died. There was a statistically significant association between digoxin and increased mortality in the unadjusted statistical analysis; however, this association disappeared after correction for clinical characteristics and comorbidities in the primary multivariable analysis (estimated hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.62-1.19, p = 0.372) and in three additional multivariable analyses. Conclusion Digoxin use as a new or preexisting medication during the acute phase of STEMI in the MAGIC trial was not associated with a significant increase in mortality after correcting for clinical characteristics and comorbidities.

Original languageEnglish (US)
Pages (from-to)176-180
Number of pages5
JournalInternational Journal of Cardiology
Volume218
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Fingerprint

Digoxin
Magnesium
Mortality
Comorbidity
Atrial Fibrillation
ST Elevation Myocardial Infarction
Proportional Hazards Models
Heart Failure
Myocardial Infarction
Confidence Intervals
Safety

Keywords

  • Digoxin
  • Mortality
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Digoxin and short term mortality after acute STEMI : Results from the MAGIC trial. / Metawee, Mohamed; Charnigo, Richard; Morales, Gustavo; Darrat, Yousef; Sorrell, Vincent; Di Biase, Luigi; Natale, Andrea; Delisle, Brian; Elayi, Claude S.

In: International Journal of Cardiology, Vol. 218, 01.09.2016, p. 176-180.

Research output: Contribution to journalArticle

Metawee, M, Charnigo, R, Morales, G, Darrat, Y, Sorrell, V, Di Biase, L, Natale, A, Delisle, B & Elayi, CS 2016, 'Digoxin and short term mortality after acute STEMI: Results from the MAGIC trial', International Journal of Cardiology, vol. 218, pp. 176-180. https://doi.org/10.1016/j.ijcard.2016.05.022
Metawee, Mohamed ; Charnigo, Richard ; Morales, Gustavo ; Darrat, Yousef ; Sorrell, Vincent ; Di Biase, Luigi ; Natale, Andrea ; Delisle, Brian ; Elayi, Claude S. / Digoxin and short term mortality after acute STEMI : Results from the MAGIC trial. In: International Journal of Cardiology. 2016 ; Vol. 218. pp. 176-180.
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abstract = "Background The safety of digoxin has been a subject of debate for decades, most recently among patients with atrial fibrillation (AF). Digoxin has been used during the acute phase of ST elevation myocardial infarction (STEMI) complicated with AF or heart failure. Data about digoxin in this setting are scarce. Hypothesis We hypothesize that digoxin maybe associated with increased mortality when used during the acute phase of ST segment myocardial infarction. Methods We investigated the association between digoxin and mortality in patients enrolled in the MAGnesium In Coronaries (MAGIC) study, which evaluated the efficacy of early magnesium administration in STEMI. Multiple Cox proportional hazards models were examined to assess the aforementioned association after correction for clinical characteristics and comorbidities. Results After excluding 639 (10.3{\%}) patients for missing data, we analyzed the remaining 5574 patients. There were 852 (15.3{\%}) deaths during the one month follow-up and 170 (3.0{\%}) patients on digoxin concomitantly, among which 42 patients (24.7{\%}) died. There was a statistically significant association between digoxin and increased mortality in the unadjusted statistical analysis; however, this association disappeared after correction for clinical characteristics and comorbidities in the primary multivariable analysis (estimated hazard ratio [HR] 0.86, 95{\%} confidence interval [CI] 0.62-1.19, p = 0.372) and in three additional multivariable analyses. Conclusion Digoxin use as a new or preexisting medication during the acute phase of STEMI in the MAGIC trial was not associated with a significant increase in mortality after correcting for clinical characteristics and comorbidities.",
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