Digoxin and cognitive performance in patients with heart failure: a cohort, pharmacoepidemiological survey.
BACKGROUND: Cognitive dysfunction is a prevalent condition among patients with heart failure (HF), and is independently associated with disability and mortality. A large study of patients with atrial fibrillation incidentally demonstrated superior cognitive performance among participants who receive...
| Publicado en: | Drugs & Aging Vol. 26; no. 2; pp. 103 - 113 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105474952&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105474952 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1170229X C5B jtl: Drugs & Aging issn: 1170229X maglogo: N pubinfo: dt: 2009 vid: 26 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 105474952 105474952 2010220431 10.2165/0002512-200926020-00002 NLM19220067 105474952 ppf: 103 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Digoxin and cognitive performance in patients with heart failure: a cohort, pharmacoepidemiological survey. aug: au: Laudisio A Marzetti E Pagano F Cocchi A Bernabei R Zuccalà G affil: Department of Gerontology, Geriatrics, and Physiatrics, Catholic University of Medicine, Rome, Italy. sug: subj: Antiarrhythmia Agents Therapeutic Use Cognition Drug Effects Digoxin Therapeutic Use Heart Failure Drug Therapy Aged Aged, 80 and Over Analysis of Variance Chi Square Test Descriptive Statistics Female Funding Source Heart Failure Complications Italy Kruskal-Wallis Test Logistic Regression Male Middle Age Human Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: BACKGROUND: Cognitive dysfunction is a prevalent condition among patients with heart failure (HF), and is independently associated with disability and mortality. A large study of patients with atrial fibrillation incidentally demonstrated superior cognitive performance among participants who received digoxin. Interestingly, endogenous cerebral digoxin influences neuronal Na(+)-dependent transport of calcium and amino acids, as well as the release and reuptake of several neurotransmitters involved in cognitive functioning. OBJECTIVE: To assess whether treatment with digoxin might improve cognition in patients with HF. METHODS: This pharmacoepidemiological cohort study included hospitalized elderly people (age >/=65 years) from the GIFA (Gruppo Italiano di Farmacoepidemiologia nell'Anziano [Italian Group of Pharmacoepidemiology in the Elderly]) study. The GIFA study included 13 598 patients (1590 with a verified diagnosis of HF) without cerebrovascular or Alzheimer's disease. The main outcome measure was cognitive performance, which was assessed on admission and immediately before discharge using the Hodkinson Abbreviated Mental Test. The diagnosis of HF was verified by the study investigators. RESULTS: Among participants with HF, cognitive performance improved in 25% of 1172 participants who received digoxin compared with 16% of remaining patients (p < 0.0001). Among participants without HF, cognition improved in 23% of 2431 patients receiving digoxin compared with 17% of untreated patients (p < 0.0001). According to logistic regression analysis, the probability (odds ratio) of improving cognitive performance associated with administration of digoxin was 1.69 (95% CI 1.20, 2.38) among patients with HF, and 1.13 (95% CI 0.98, 1.31) among patients without HF, after adjusting for potential confounders. Analysis of the interaction term 'use of digoxin by diagnosis of HF' in fully adjusted logistic regression confirmed (p = 0.018) that the association between use of digoxin and improving cognitive performance varied according to diagnosis of HF. CONCLUSION: Treatment with digoxin might selectively improve cognitive performance among older patients with HF. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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