Analyzing gender and racial effects of digoxin vs diltiazem in atrial fibrillation mortality using large EHR data

Digoxin is an atrial fibrillation (AF) rate control drug that is still in use. New randomized trial data comparing digoxin with other agents is unlikely to become available, but observational data exists in the form of large patient databases. We compared the mortality rates between Digoxin and Diltiazem using the Cerner Healthfacts Data. The study was performed on data with 52,775 U.S. patients with atrial fibrillation. The goal of the study was to assess the mortality versus survival rates between patients. Patients’ characteristics were reviewed among those receiving either a calcium channel antagonist (diltiazem) or digoxin. The mortality rates for patients who took digoxin were greater than that of patients who took diltiazem and had 1.31 times the risk of mortality [5.23% vs 3.98%, RR 1.31, CI 1.21-1.42, p < 0.001]. African Americans had the highest mortality rate compared to other races [6.28%, p<0.0001]. The age (in years) of patients treated with digoxin was higher than that of patients treated with diltiazem [74.96 vs 68.45, p<0.0001]. Length of stay (in days) of patients with digoxin was also significantly higher than that of diltiazem patients [74.96 vs 68.45, p<0.0001; 5.95 vs 4.99, p<0.0001]. Within certain races, digoxin mortality rates were higher between male and female patients. The mortality rate differences show adverse outcomes and increased risk of mortality was found in patients taking digoxin.