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Outcomes of digoxin vs. beta blocker in atrial fibrillation: report from ESC–EHRA EORP AF Long-Term General Registry
Wern Yew Ding, Giuseppe Boriani, Francisco Marı́n, Carina Blomström‐Lundqvist, Tatjana Potpara, Laurent Fauchier, Gregory Y.H. Lip, G Y H Lip, Luigi Tavazzi, Aldo P. Maggioni, G-A Dan, Z Kalarus, G Mairesse, L Antoniades, Miloš Táborský, S Riahi, P Muda, I García Bolao, Εmmanuel Simantirakis, Moti Haim, Amirhossein Azhari, J Najafian, Massimo Santini, K a Kulzida, A Erglis, L Poposka, M Burg, H Crijns, Ö Erküner, R Lenarczyk, Mário Oliveira, Dipen Shah, E Diker, D Lane, E Zëra, U Ekmekçiu, V Paparisto, Mihal Tase, H Gjergo, J Dragoti, M Ciutea, N Ahadi, Ziad El Husseini, M. Raepers, J. Leroy, P Haushan, A Jourdan, Caroline Lepièce, L Desteghe, Johan Vijgen, P Koopman, G. Van Genechten, Hein Heidbüchel, Tim Boussy, M De Coninck, Hannelore Van Eeckhoutte, N Bouckaert, A Friart, J Boreux, C Arend, P Evrard, L Stefan, E Hoffer, J Herzet, M Massoz, C Celentano, M Sprynger, L Pierard, P Melon, B Van Hauwaert, C Kuppens, D Faes, Dirk van Lier, A. Van Dorpe, A Gerardy, Olivier Deceuninck, Olivier Xhaët, Fabien Dormal, Elisabeth Ballant, D Blommaert, D. Yakova, M Hristov, T Yncheva, N Stancheva, S. Tisheva, Mariya Tokmakova, F Nikolov, D Gencheva, B. Kunev, M Stoyanov, D Marchov, V Gelev, Vassil Traykov, Аntoniya Kisheva, H Tsvyatkov, R Shtereva, S Bakalska-Georgieva, S Slavcheva, Yoto Yotov, Milena Kubíčková, A Marni Joensen, Anders Gammelmark, Lars Hvilsted Rasmussen, P Dinesen, S Krogh Venø, B Sorensen, A Korsgaard, Karl Andersen, C Fragtrup Hellum, A Svenningsen, Ole Nyvad, P Wiggers, O May, A Aarup, B Graversen, Lisette Okkels Jensen, Mikkel Porsborg Andersen, M Svejgaard, S Vester, S. Hansen, Vibeke Lynggaard, M Ciudad, R Vettus, Ana M. Maestre, S Castaño, S. Cheggour, J Poulard, V Mouquet, S Leparrée, J Bouet, Julien Taı̈eb, A Doucy, H Duquenne, Alain Furber, J Dupuis, J Rautureau, Maria Àngels Font, P. Damiano, M Lacrimini, J Abalea, S Boismal, T Menez, Jacques Mansourati, Grégoire Rangé, Hervé Gorka, C Laure, C Vassalière, N. Elbaz, N Lellouche, K Djouadi, François Roubille, D Dietz, Jean‐Marc Davy, M Granier, Pierre Winum, C Leperchois-Jacquey, H Kassim, E Marijon, J Le Heuzey, J Fedida, Carole Maupain, C Himbert, Estelle Gandjbakhch, Françoise Hidden‐Lucet, Guillaume Duthoit, N Badenco, T Chastre, X Waintraub, M Oudihat, J Lacoste, Carrie Stephan, H Bader, N Delarche, L Giry, D Arnaud, Camden Lopez, F Boury, I Brunello, Michael Lefevre, Rozenn Mingam, Michel Haı̈ssaguerre, M Le Bidan, Dominique Pavin, Valérie Moal, Christophe Leclercq, T Beitar, I. Martel, Anita N. Schmid, N Sadki, C Romeyer-Bouchard, Alessandro Costa, I Arnault, M Boyer, C Piat, N Lozance, S Nastevska, A Doneva, B Fortomaroska Milevska, B Sheshoski, K Petroska, N Taneska, N Bakrecheski, K Lazarovska, S Jovevska, V Ristovski, A Antovski, Elena Lazarova, I Kotlar, J Taleski, S Kedev, N Zlatanovik, S Jordanova, T Bajraktarova Proseva, S Doncovska, D Maisuradze, A Esakia, E Sagirashvili, K Lartsuliani, N Natelashvili, N Gumberidze, R Gvenetadze, N Gotonelia, N Kuridze, G Papiashvili, I Menabde, S Glöggler, A Napp, Corinna Lebherz, H Romero, Karl-Heinz Schmitz, M Berger, Matthias Daniel Zink, S Köster, J Sachse, E Vonderhagen, G Soiron, K Mischke, R Reith, M Schneider, W Rieker, D Boscher, A Taschareck, A Beer, D Oster, Oliver Ritter, J Adamczewski, Sabine Walter, A Frommhold, E Luckner, J Richter, M Schellner, S Landgraf, S Bartholome, J Schoeler, D Westermeier, F William, K Wilhelm, M Maerkl, R Oekinghaus, M Denart, M Kriete, U Tebbe, T Scheibner, M Gruber, Anthony T. Gerlach, C Beckendorf, L Anneken, Markus Arnold, S Lengerer, Z Bal, C Uecker, H Förtsch, S Fechner, V Mages, E Martens, Heiko Methe, T Schmidt, B Schaeffer, B Hoffmann, J. Moser, K Heitmann, S Willems, C. Klaus, I.R. Lange, Monika Durak, E Esen, F Mibach, H Mibach, A Utech, M. Gabelmann, R Stumm, V Ländle, C Gartner, C Goerg, N Kaul, S Messer, D Burkhardt, Christian Sander, R Orthen, S Kaes, Anselm T. Bäumer, F Dodos, Andreas S. Barth, G Schaeffer, Jan Gaertner, J Winkler, A Fahrig, J Aring, I Wenzel, S Steiner, A Kliesch, Ewa Maria Kratz, Klaus-Dieter Winter, P. Schneider, Aaron Haag, I Mutscher, Ralph Bosch, J Taggeselle, S Meixner, A. Schnabel, A Shamalla, Holger Hotz, A Korinth, C Rheinert, G Mehltretter, B Schön, N Schön, A Starflinger, E Englmann, G Baytok, T. Laschinger, Guido Ritscher, A Gerth, Dirk G. Dechering, Lars Eckardt, Martin K. Kuhlmann, N Proskynitopoulos, J Brunn, K Foth, C Axthelm, H. Hohensee, K Eberhard, S Turbanisch, N Hassler, A Koestler, G Stenzel, D Kschiwan, Markus Schwefer, S Neiner, S Hettwer, M Haeussler-Schuchardt, Ralf Degenhardt, S Sennhenn, Matthias Brendel, Albrecht Stoehr, W Widjaja, S. Loehndorf, A Logemann, J Hoskamp, J Grundt, M Block, R Ulrych, Anja Reithmeier, Vasilios Panagopoulos, C Martignani, Davide Bernucci, Igor Diemberger, Matteo Ziacchi, M Biffi, Paolo Cimaglia, J Frisoni, I. Giannini, S Boni, Stefano Fumagalli, Simone Pupo, A Di Chiara, P Mirone, Francesco Pesce, C Zoccali, V L Malavasi, A Mussagaliyeva, B Ahyt, Z Salihova, K. Koshum‐bayeva, Alina Kerimkulova, A Bairamukova, B Lurina, R Zuzans, S Jegere, I Mintale, Kaspars Kupics, Kristine Jubele, O Kalejs, K Vanhear, M Cachia, E Abela, S Warwicker, T Tabone, Robert G. Xuereb, D Asanovic, D Drakalovic, M Vukmirovic, Nikola Pavlović, L Music, Nebojša Bulatović, A Boskovic, H Uiterwaal, Nick R. Bijsterveld, Jan Cees de Groot, Jolien Neefs, N van den Berg, Femke R. Piersma, A Wilde, V Hagens, Jan van Es, Jurren M. van Opstal, B Van Rennes, H Verheij, W Breukers, G Tjeerdsma, R. Nijmeijer, D Wegink, R Binnema, S Said, Suzanne Philippens, Wouter van Doorn, Tamás Szili‐Törok, R Bhagwandien, P. Janse, A Muskens, Martijn van Eck, R Gevers, N van der Ven, A. Duygun, B Rahel, Joan G. Meeder, A Vold, C Holst Hansen, I Engset, B Dyduch-Fejklowicz, E Koba, M Cichocka, A Sokal, A Kubicius, E Pruchniewicz, A Kowalik-Sztylc, W Czapla, I Mróz, Michał Kozłowski, Tom Pawlowski, Michał Tendera, A Winiarska-Filipek, A Fidyk, A Slowikowski, Maciej Haberka, M Lachor-Broda, M Biedron, Z Gasior, Małgorzata Kołodziej, Marianna Janion, Iwona Gorczyca−Michta, B Wozakowska-Kaplon, M Stasiak, Piotr Jakubowski, Tomasz Ciuruś, J Drozdz, M Simiera, P Zajac, Tomasz Wcisło, P Zycinski, Jarosław D. Kasprzak, Anna Olejnik, E Harc-Dyl, J Miarka, M Pasieka, M Ziemińska-Łuć, W Bujak, Anthony J. Sliwinski, A Grech, J Morka, K Petrykowska, M Prasał, G Hordyński, Piotr Feusette, Przemysław Lipski, A Wester, W Streb, J Romanek, P Woźniak, M Chlebuś, P Szafarz, W Stanik, M Zakrzewski, J Kaźmierczak, A Przybylska, E Skorek, H. Błaszczyk, M. Stępień, S Szabowski, W Krysiak, M Szymańska, J. Karasiński, J Blicharz, M Skura, K Hałas, Łukasz Michalczyk, Zbigniew Orski, K Krzyżanowski, A Skrobowski, L Zieliński, Monika Tomaszewska‐Kiecana, Mirosław Dłużniewski, M Kiliszek, M Peller, M Budnik, Paweł Balsam, Grzegorz Opolski, Agata Tymińska, Krzysztof Ozierański, Anna Wancerz, Agnieszka Borowiec, E Majos, Rafał Dąbrowski, H Szwed, A. Musialik-Lydka, A Leopold-Jadczyk, Ewa Jędrzejczyk‐Patej, Monika Kozieł, M Mazurek, K Krzemien-Wolska, P Starosta, Ewa Nowalany-Kozielska, Aleksandra Orzechowska, M Szpot, M Staszel, S Almeida, Hélder Pereira, L Brandão Alves, R Miranda, Leonardo Coutinho Ribeiro, Francesco Costa, F Morgado, Plínio Resende do Carmo, P Galvao Santos, R Bernardo, Pedro Adragão, G Ferreira da Silva, M Peres, Marta Alves, M Leal, A Cordeiro, Pedro Magalhães, P Fontes, Sílvia Leão, Ana Sofia Delgado, A Costa, Bruno Marmelo, Bruno Rodrigues, D Moreira, J Santos, L Santos, A Terchet, D Darabantiu, S Mercea, V Turcin Halka, A Pop Moldovan, A Gabor, B Doka, G Catanescu, H Rus, L Oboroceanu, Elena Bobescu, R Popescu, A Dan, A Buzea, I. Daha, G-A Dan, I Neuhoff, M Baluta, R Ploesteanu, N Dumitrache, M Vintila, A Daraban, C. Japie, E Badila, H Tewelde, Mihaela Hostiuc, S Frunza, E Tintea, D. Bartos, A Ciobanu, I Popescu, N Toma, C Gherghinescu, D Cretu, N Patrascu, Claudiu Stoicescu, Cristian Alexandru Udroiu, G Bicescu, V. Vintila, Dragoş Vinereanu, M Cinteza, Roxana Cristina Rimbaş, M Grecu, A Cozma, F Boros, M Ille, Otilia Țica, Ruth Tor, A. Corina, A Jeewooth, B Maria, C Georgiana, D Alin, D Dinu-Andrei, M Livia, R Daniela, R Larisa, S Umaar, T. Tamara, M Ioachim Popescu, Daciana Nistor, I Sus, O Coborosanu, N Alina-Ramona, R. Dan, L Petrescu, G Ionescu, C Vacarescu, Emilia Goanță, M Mangea, Adina Ionac, Cristian Mornoş, Dragoș Cozma, S Pescariu, E Solodovnicova, J Shutova, L Tjuleneva, T Zubova, V Uskov, D Obukhov, G Rusanova, N Isakova, S Odinsova, T Arhipova, Е. В. Казакевич, O Zavyalova, T Novikova, I. Riabaia, S Zhigalov, E Drozdova, I Luchkina, Y Monogarova, D Hegya, L Rodionova, В. А. Невзорова, I Soldatova, O Lusanova, Aleksandra Arandjelovic, D Toncev, L Vukmirovic, Miša Radisavljević, M Milanov, Nikola Šekularac, Marija Zdravković, S Hinic, S Dimkovic, T. Acimovic, J Saric, S. Radovanović, Aleksandar Kocijančić, B Obrenovic-Kircanski, D. Kalimanovska Ostric, Ivan Jovanović, I Petrovic, Marija Polovina, M. Vukicevic, M Tomasevic, Nataša Mujović, N. Radivojevic, O Petrovic, S Aleksandric, V Kovacevic, Z Mijatovic, B Ivanovic, A Ristic, B Vujisic-Tesic, Milan Nedeljković, A Karadzic, A Uscumlic, M Prodanovic, M. Zlatar, Milika Ašanin, B Bisenic, V Vasić, Zoran Popović, D Djikic, M Sipic, V Peric, Božidar Dejanović, Nikola Milošević, S Backovic, A Stevanovic, A Andric, B Pencic, M. Pavlovic‐kleut, Vera Celic, Mirko Petrović, M. Vuleta, Nemanja Petrović, Stefan Simović, Z Savovic, S Milanov, Goran Davidović, Violeta Irić-Ćupić, D Djordjevic, M Damjanovic, S Zdravkovic, Vesna Topić, Dragana Stanojević, M. Randjelovic, R Jankovic-Tomasevic, V Atanaskovic, Svetlana Antić, D. Simonovic, Milovan Stojanović, S Stojanovic, V Mitic, V Ilic, D Petrovic, Milan Ilić, Sanja Ilic, V Stoickov, Snežana Marković, A Mijatovic, D Tanasic, G Radakovic, J Peranovic, M Pavlovic, N Panic-Jelic, O Vujadinovic, P Pajic, Sanja Bekić, Sanjin Kovačević, A García Fernandez, A Perez Cabeza, M Anguita, E. Mau, J Loayssa, M Ayarra, M Carpintero, Inmaculada Roldán Rabadán, M. Gil Ortega, A Tello Montoliu, E Orenes Piñero, Sergio Manzano‐Fernández, A Romero Aniorte, A Veliz Martínez, Manuel Giner, G Ballesteros, M. Palacio, O Alcalde, Ignacio García‐Bolao, Vicente Bertomeu‐González, F Otero-Raviña, J García Seara, José Ramón González‐Juanatey, N Dayal, P Maziarski, Pascale Gentil-Baron, Mevlüt Koç, E Onrat, İbrahim Etem Dural, Kerem Can Yılmaz, Bülent Özin, S Tan Kurklu, Yusuf Atmaca, Uğur Canpolat, Lâle Tokgözoğlu, Abdullah Kadir Dolu, B Demirtas, Deniz Şahin, O Ozcan Celebi, G Gagirci, Uğur Önsel Türk, H Ari, Nihat Polat, Nizamettin Toprak, Murat Sucu, Osman Akın Serdar, A Taha Alper, A Kepez, Y Yuksel, A Uzunselvi, S Yuksel, M Sahin, Osman Kayapınar, T Ozcan, Hasan Kaya, Mehmet Birhan Yılmaz, Merih Kutlu, Mahmut Demir, C Gibbs, Svetlana Kaminskienė, M Bryce, A Skinner, G Belcher, James Hunt, L Stancombe, B Holbrook, C Peters, S Tettersell, Alena Shantsila, Keitaro Senoo, Marco Proietti, K Russell, Pedro Rauel Cândido Domingos, Syed Nubaid Hussain, Judith Partridge, R Haynes, S Bahadur, R Brown, Susan D. McMahon, G Y H Lip, J.A. McDonald, K Balachandran, Ranjit D. Singh, Scot Garg, Himanshu Desai, Kelvin J.A. Davies, W Goddard, G Galasko, I Rahman, Yeow Leng Chua, O Payne, S Preston, O Brennan, L. Pedley, Catharine Whiteside, C Dickinson, J Brown, Kelly Jones, L Benham, R Brady, L Buchanan, A Ashton, Helen Crowther, H Fairlamb, S Thornthwaite, C Relph, Anna McSkeane, Una Poultney, N Kelsall, P Rice, T Wilson, M Wrigley, Riyaz A. Kaba, T Patel, Emma Young, Jonathan P. Law, C Runnett, H Thomas, H McKie, J Fuller, Sara Pick, A Sharp, A Hunt, Kevin E. Thorpe, C Hardman, E Cusack, L Adams, M Hough, Samantha Keenan, A Bowring, James A. Watts, J Zaman, Karolien Goffin, H Nutt, Y. Beerachee, J Featherstone, C Mills, J Pearson, L Stephenson, Shakira J. Grant, A Wilson, C Hawksworth, Irfan Alam, M Robinson, Sarah Ryan, R Egdell, E Gibson, M Holland, D Leonard, B Mishra, S Ahmad, H Randall, J Hill, L Reid, M George, S. McKinley, L Brockway, W Milligan, Jolanta Sobolewska, J Muir, L Tuckis, L Winstanley, P Jacob, S Kaye, L Morby, A Jan, T Sewell, C Boos, B Wadams, Constantin Cope, P Jefferey, Noah Andrews, Allyson K. Getty, A Suttling, C. Turner, Kathleen Hudson, R Austin, S Howe, Rabia Iqbal, N Gandhi, K Brophy, P Mirza, E Willard, S Collins, Ntokozo Ndlovu, Eduardas Subkovas, V. Karthikeyan, L Waggett, Amanda Wood, A Bolger, J Stockport, L Evans, Ece Harman, J Starling, Livia Williams, V Saul, Michael S. Sinha, L. Bell, S Tudgay, S Kemp, Lars Frost, T Ingram, Anita M. Loughlin, Casey Adams, M Adams, F Hurford, Clarence H. Owen, Chris Miller, Denise Donaldson, Helen Tivenan, Heather Button, A Nasser, O Jhagra, B Stidolph, C Brown, C Livingstone, Merry Duffy, P Madgwick, P Roberts, Elizabeth Greenwood, L Fletcher, M Beveridge, S Earles, David McKenzie, D Beacock, Mark Dayer, M Seddon, D Greenwell, F Luxton, F Venn, H Mills, J Rewbury, K James, K Roberts, Louise Tonks, D Felmeden, W Taggu, A Summerhayes, D Hughes, J Sutton, L Felmeden, M Khan, E Walker, L Norris, L O’Donohoe, A Mozid, H Dymond, Hannah Lloyd-Jones, G. Saunders, David N. Simmons, D Coles, D Cotterill, S Beech, Stephen Kidd, Benjamin Wrigley, Sanjiv Petkar, Andrew Smallwood, Robert Jones, E Radford, Sarah Milgate, Stella Metherell, V Cottam, C Buckley, A Broadley, D Wood, J Allison, Kirsten L. Rennie, L Balian, L Howard, L Pippard, S Board, T Pitt-Kerby
Bibliographic record
VenueEuropean Heart Journal - Cardiovascular Pharmacotherapy · 2021
Typearticle
Languageen
FieldMedicine
TopicAtrial Fibrillation Management and Outcomes
Canadian institutionsnot available
FundersAbbott VascularNovartis PharmaBristol-Myers Squibb CanadaServierVifor PharmaNational Institute for Health and Care ResearchBoston Scientific CorporationSanofiAstraZenecaEli Lilly and CompanyResMed FoundationBoehringer IngelheimAmgenBayerGedeon Richter
KeywordsAtrial fibrillationDigoxinMedicineCardiologyInternal medicineTerm (time)Beta blockerHeart failurePhysics
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.211
Threshold uncertainty score1.000
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.004 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
Opus teacher head0.065
GPT teacher head0.354
Teacher spread0.289 · how far apart the two teachers sit on this one work
Validation status
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
Study designObservational
Domainnot available
GenreEmpirical
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".
Quick stats
Citations5
Published2021
Admission routes1
Has abstractyes