Association of Digoxin Application Approaches With Long-Term Clinical Outcomes in Rheumatic Heart Disease Patients With Heart Failure: A Retrospective Study

Abstract

Objective: This retrospective, case–control study was executed to assess the effects of digoxin (DGX) use approaches [continuous use of DGX (cDGX) vs. intermittent use of DGX (iDGX)] on the long-term prognosis in rheumatic heart disease (RHD) patients with heart failure (HF).Methods: A total of 642 RHD patients were enrolled to this study after propensity matching. The associations of DGX application approaches with the risks of all-cause mortality, cardiovascular death (CVD), HF re-hospitalization (1-, 3-, and 5-year), and new-onset atrial fibrillation (AF) were analyzed by multivariate Cox proportional hazards or binary logistic regression models, respectively.Results: cDGX was associated with increased risks of all-cause mortality (adjusted HR = 1.84, 95% CI: 1.27–2.65, P = 0.001) and CVD (adjusted HR = 2.23, 95% CI: 1.29–3.83, P = 0.004) in RHD patients with HF compared to iDGX. With exception of 1-year HF re-hospitalization risk, cDGX was associated with increased HF re-hospitalization risk of 3-year (adjusted OR = 1.53, 95% CI: 1.03–2.29, P = 0.037) and 5-year (adjusted OR = 1.61, 95% CI: 1.05–2.50, P = 0.031) as well as new-onset AF (adjusted OR = 2.06, 95% CI: 1.09–3.90, P = 0.027).Conclusion: cDGX was significantly associated with increased risks of all-cause mortality, CVD, medium-/long-term HF re-hospitalization, and new-onset AF in RHD patients with HF.

Circular Network of Coregulated Sphingolipids Dictates Chronic Hypoxia Damage in Patients With Tetralogy of Fallot

“…In this study, it is important to mention the role of sphingolipid metabolism, which regulates the activity of cardiac glycolysis and structural and electrical remodeling involved in chronic hypoxic environments (39). Liu et al (40)(41)(42) found that metabolic disorders of myocardial tissue in response to diverse pathological stimulus conditions, including ischemia reperfusion (I/R) injury, metabolic myocardial damage, and defects in hypoxia, play a critical role in the clinical prediction, diagnosis, and targeted treatment of cardiovascular disease. Wang et al (43) demonstrated that the main cause of cardiac microvascular I/R injury is the no-reflow phenomenon after thrombolytic or revascularization therapy in patients with myocardial infarction.…”

Metastatic patterns and prognosis of patients with primary malignant cardiac tumor

“…Among multivariate Cox regression analyses, all variables in univariate analysis with p -value < 0.05 were entered into model 1 (age at diagnosis, median household income, histopathology and size); Model 2: it is the same as Model 1, and also including sex. Sex is one of the important sociodemographic characteristics in cardiovascular disease; Model 3: it is the same as Model 2, and also including surgery ( 21 – 23 ). Surgical resection is one of the important treatments of PMCT.…”