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Abstract

Congestive heart failure (CHF) is a leading cause of hospitalization and mortality worldwide. Digoxin, a commonly used medication in the management of CHF, requires careful monitoring due to its narrow therapeutic range. This study aimed to evaluate the correlation between serum digoxin levels and clinical outcomes in patients with CHF. This observational study included 100 adult patients diagnosed with CHF who were treated with digoxin and admitted to the cardiopulmonary department at a hospital between 2023 and 2024. Serum digoxin levels were measured on admission and throughout the hospital stay if clinically indicated. Clinical outcomes, including hospitalization duration, incidence of adverse events, and overall mortality, were recorded. Statistical analysis was performed to assess the correlation between serum digoxin levels and these clinical outcomes. Serum digoxin levels ranged from 0.2 ng/mL to 3.5 ng/mL, with an average of 1.6 ng/mL. Forty-five percent of patients had therapeutic levels (0.5–2.0 ng/mL), 35% had sub-therapeutic levels, and 20% had toxic levels. Patients with toxic levels had a higher incidence of arrhythmias, gastrointestinal symptoms, and heart block compared to those with therapeutic levels. Hospitalization duration was significantly longer in patients with sub-therapeutic and toxic levels. The mortality rate was 5%, all occurring in patients with toxic levels. Pearson's correlation analysis showed a significant positive association between serum digoxin levels and adverse events (r = 0.45, p < 0.01). Elevated serum digoxin levels, particularly those above the therapeutic range, are associated with adverse clinical outcomes, including increased hospital stay, adverse events, and higher mortality. These findings emphasize the importance of monitoring digoxin levels in CHF patients to optimize treatment and minimize risks.