Inappropriate use of digoxin in patients presenting with digoxin toxicity

Tatlisu M. A., Ozcan K. S., Gungor B., Zengin A., Karatas M. B., NURKALEM Z.

Journal of Geriatric Cardiology, vol.12, no.2, pp.143-146, 2015 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 12 Issue: 2
  • Publication Date: 2015
  • Doi Number: 10.11909/j.issn.1671-5411.2015.02.007
  • Journal Name: Journal of Geriatric Cardiology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.143-146
  • Keywords: Digoxin, Ejection fraction, Indications, Toxicity
  • Istanbul Medipol University Affiliated: Yes


Background: Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of elderly patients hospitalized for digoxin toxicity. Methods: The study included 99 consecutive patients hospitalized for digoxin toxicity. The other study criteria for the inappropriate use of digoxin was regarded if participants having depressed left ventricular systolic function (ejection fraction < 45%) who were not on optimal medical therapy including beta-blocker and angiotensin-converting-enzyme inhibitor therapy or if participants having permanent AF who were not on optimal beta-blocker therapy. Results: Appropriate digoxin usage was confirmed in 33 of patients in spite of its narrow thera-peutic index. A total of 16 of 99 patients died, with a mean follow-up time of 22.1 ± 10.3 months. Conclusions: Contrary to popular belief, the rate of inappropriate digoxin usage remains high. On account of its narrow therapeutic index and toxicity, digoxin should be used more carefully according to the current evidence and guidelines.