Digoxinemia interpretation : factors to be considered

Abstract

Digoxin is a narrow therapeutic cardiotropic that can induce severe digitalis poisoning. The objective of our work is to study the involvement of phy-siological, pathological and therapeutic factors in the increase of digoxinemia. This prospective study includes 113 patients aged 32-87 years treated with digoxin, and consulting for presumption of overdose. Digoxin levels above the-rapeutic concentrations at 21.1% of our patients, with higher increase among women and even more regarding the weekly dose of digoxin. Digoxinemia is higher in patients over 60 years (p < 0.02), those with heart failure (p < 0.02) and those treated with other cardiovascular drugs in association : ACE inhibitors (p < 0.001), diuretics (p <0.01), amiodarone (p <0.01), Vs. patients treated with digoxin alone. When other medications (β-blockers, diuretics, NSAIDs or dil-tiazem) were associated with an ACE inhibitor
plus digoxin, digoxinemia spend of 1.57 ± 1.84 to 2.69 ± 3.71 mg/L. In cases where these drugs are associated with amiodarone and digoxin, digoxinemia spend of 1.69 ± 1.32 to 4.08 ± 3.60 mg/L. For high digoxinemia, interpreta-tion should take into consideration the age, sex, dosage, the existence of heart failure, and treatment with ACE inhibitors and amiodarone.