Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States of America.
Cardiovascular Division, Electrophysiology Section, University of Minnesota, Minneapolis, MN, United States of America.
PLoS One. 2019 Nov 25;14(11):e0225628. doi: 10.1371/journal.pone.0225628. eCollection 2019.
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.
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.
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).
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.
虽然左心室辅助装置（LVAD）的临床经验不断发展，但对于该人群中某些药物的持续使用知之甚少。我们旨在评估地高辛在 LVAD 受者中的应用价值及其与结局的相关性。
共纳入 2007 年至 2015 年间 5 个中心接受连续血流 LVAD 植入的 505 例患者。患者分为 4 组：任何时候均未用地高辛（ND；n = 257）、植入前用地高辛（PreD；n = 144）、植入前后均用地高辛（ContD；n = 55）和仅植入后用地高辛（PostD；n = 49）。比较 4 组间的生存和全因再入院情况。
各组间 1 年和 3 年生存率无差异（ND = 88%，66%；PreD = 85%，66%；ContD = 86%，57%；PostD = 90%，51%；p = 0.7）。每 100 天再入院率也无差异（ND = 0.5，PreD = 0.6，ContD = 0.5，PostD = 0.7；p = 0.1）。
在这项大型多中心队列研究中，连续血流 LVAD 支持患者使用地高辛与死亡率或住院率无显著相关性。重要的是，植入后停用地高辛并未增加全因住院或死亡风险。
