Serum digoxin levels and mortality in 5,100 patients

Annals of Emergency Medicine
G J OrdogS Balasubramanium

Abstract

A retrospective study of 5,100 patients on digoxin, with a four-week follow up after digoxin levels were measured, was done to determine the mortality rate. A significant increase in mortality was correlated with an increasing serum digoxin level, up to 50% at a level of 6.0 ng/mL and more. Clinical toxicity was suspected in only 0.25% of all patients on digoxin, although almost 10% had levels above the therapeutic range. Deliberate digoxin overdoses were fatal in 50% of cases. This study shows a correlation between increasing digoxin levels and increasing mortality rates. We recommend the use of serum digoxin measurements to identify those asymptomatic patients with elevated levels. The physician should seriously consider the indications for initiating or continuing digoxin treatment in any patient because of an increased mortality in patients with levels of more than 1.0 ng/mL.

References

Jan 1, 1976·American Heart Journal·D H HuffmanD L Azarnoff
Feb 8, 1973·The New England Journal of Medicine·F Coughlin
Feb 28, 1973·Clinica Chimica Acta; International Journal of Clinical Chemistry·J J ZeegersG Jambroes
Dec 1, 1973·Archives of Internal Medicine·L W RitzmannJ R Walsh
Feb 1, 1974·The Journal of Pediatrics·R KrasulaL F Soyka
Nov 1, 1966·The American Journal of Medicine·J F Hoffman
Nov 27, 1969·The New England Journal of Medicine·T W SmithE Haber
Dec 1, 1970·The Journal of Clinical Investigation·T W Smith, E Haber
Jul 1, 1971·British Heart Journal·D C Evered, C Chapman
Jan 1, 1966·The American Journal of Cardiology·J E Doherty, W H Perkins
Jan 1, 1967·Annals of Internal Medicine·J E DohertyW J Flanigan

Citations

May 1, 1991·Journal of Clinical Pharmacology·M DickD Tepper
Apr 5, 2008·Intensive Care Medicine·Frédéric LapostolleFrédéric Adnet
May 24, 2012·Cardiovascular Toxicology·Saurabh RajpalPratap Reddy
Feb 24, 2001·The Journal of Emergency Medicine·G MaT C Chan
Feb 23, 2012·Seminars in Dialysis·Robert Clark SchuttMitchell H Rosner
Nov 10, 2004·Medical Hypotheses·Lexin Wang, Shukai Song
Mar 1, 1991·The American Journal of Emergency Medicine·M J Bayer
Jun 30, 2000·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M ZdunekM H Mokrzycki
Dec 3, 1999·Journal of Clinical Pharmacy and Therapeutics·R PähklaL Rootslane
Sep 2, 2006·Journal of Intensive Care Medicine·David P BettenRichard F Clark
Mar 11, 2005·Autonomic & Autacoid Pharmacology·A T Demiryürek, S Demiryürek
Apr 25, 2000·Therapeutic Drug Monitoring·F Abad-SantosJ Frías
May 31, 2016·Turkish Journal of Emergency Medicine·Gulsum LimonOnder Limon
Mar 18, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Kazutaka AonumaJapanese Circulation Society and the Japanese Society of Therapeutic Drug Monitoring Joint Working Group
May 31, 2011·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Alex F ManiniRobert S Hoffman
Aug 31, 2002·Medicine, Science, and the Law·María S Rodríguez-CalvoLuis Concheiro
Oct 1, 1996·The Annals of Pharmacotherapy·B K Wagner
Jan 15, 1990·The Medical Journal of Australia·P R Pentel, D M Salerno

Related Concepts

Mapluxin
Electrocardiographic Recorders
Heart Diseases
Decline, Mortality
Retrospective Studies
Suicide
Suicide Attempt

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Lipidomics & Rhinovirus Infection

Lipidomics can be used to examine the lipid species involved with pathogenic conditions, such as viral associated inflammation. Discovered the latest research on Lipidomics & Rhinovirus Infection.

Alzheimer's Disease: MS4A

Variants within the membrane-spanning 4-domains subfamily A (MS4A) gene cluster have recently been implicated in Alzheimer's disease in genome-wide association studies. Here is the latest research on Alzheimer's disease and MS4A.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Torsion Dystonia

Torsion dystonia is a movement disorder characterized by loss of control of voluntary movements appearing as sustained muscle contractions and/or abnormal postures. Here is the latest research.

Generating Insulin-Secreting Cells

Reprogramming cells or using induced pluripotent stem cells to generate insulin-secreting cells has significant therapeutic implications for diabetics. Here is the latest research on generation of insulin-secreting cells.

Central Pontine Myelinolysis

Central Pontine Myelinolysis is a neurologic disorder caused most frequently by rapid correction of hyponatremia and is characterized by demyelination that affects the central portion of the base of the pons. Here is the latest research on this disease.

Epigenome Editing

Epigenome editing is the directed modification of epigenetic marks on chromatin at specified loci. This tool has many applications in research as well as in the clinic. Find the latest research on epigenome editing here.

Related Papers

JAMA : the Journal of the American Medical Association
G H GleesonA R Ticzon
JAMA : the Journal of the American Medical Association
T Risler, B Grabensee
JAMA : the Journal of the American Medical Association
S E Warren, D D Fanestil
© 2021 Meta ULC. All rights reserved