The measurement of Digoxin serum level (DSL) in patients with heart disease and its relation with age

Background and objective: With regard to the extensive use of digoxin in patients with heart disease and its high prevalence of toxicity, this study was done to measure the digoxin serum level (DSL) in patients with or without symptoms of poisoning and determine its relation with age. Methods: This study was performed on 441 patients who used digoxin in Babol Shahid Beheshti hospital in 1999-2003. Digoxin has been used for a long time by these patients and the cause of hospitalization was symptoms related to digoxin and primary disease. DSL was measured after history taking and information about the presence of poisoning symptoms. Finding: From 441 patients, 63 cases were toxic and 378 cases were non-toxic. Among 63 toxic cases, DSL in 27 cases was more than 2 ng/dl in serum that 82% of them were under 70 years old and DSL in 36 cases was less than 2 ng/dl in serum that 95% of them were over 70 years. From 378 non-toxic cases, 42 cases (11%) were over 70 years that DSL in all of them was less than 2 ng/dl and 336 (89%) were under 70 years that DSL in 3 (4%) and 323 (96%) was more and less than 2 ng/dl, respectively. Conclusion: Although, the most DSL in non-toxic patients was more than 2 ng/dl but DSL less than 2 ng/dl can also cause digoxin toxicity (Especially in patients more than 70 years)