Rivinius R, et al. - The impacts of chronic digitalis therapy prior to heart transplantation (HTX) on posttransplant outcomes are explored in this study. The current study showed that the digitalis in patients before HTX is an independent risk factor for increased posttransplant mortality.

Methods

• For this research, they designed a retrospective, observational, single-center study.
• They included total 530 adult patients who were heart-transplanted at Heidelberg University Hospital between 1989 and 2012.
• Patients with digitalis prior to HTX (≥3 months) were compared to those without (no or <3 months of digitalis).
• Patients with digitalis were further subdivided into patients receiving digoxin or digitoxin.
• Primary outcomes were early post-transplant atrial fibrillation and mortality.

Results

• They found a total of 347 patients (65.5%) had digitalis before HTX.
• Among these, 180 received digoxin (51.9%) and 167 received digitoxin (48.1%).
• Patients with digitalis before HTX had a significantly lower 30-day (P=0.0148) and 2-year (P=0.0473) survival.
• No significant difference was seen between digoxin and digitoxin in 30-day (P=0.9466) or 2-year (P=0.0723) survival.
• Multivariate analysis for posttransplant 30-day mortality demonstrated pretransplant digitalis therapy as an independent risk factor (hazard ratio =2.097, CI: 1.036-4.248, P=0.0397).
• Regarding atrial fibrillation in the early posttransplant period, there was neither a statistically significant difference between patients with and without digitalis (P=0.1327) nor between patients with digoxin or digitoxin (P=0.5867).