{
  "abstract": "Background and Importance Digoxin is a high-risk medication frequently prescribed for heart failure and atrial fibrillation, but its narrow therapeutic index makes toxicity a persistent clinical concern, particularly among older patients. Previous evidence suggests potential sex-related differences in susceptibility to digoxin intoxication; however, data remain limited. A better understanding of these differences could help optimise dosing strategies and enhance patient safety.Aim and Objectives To evaluate sex differences in digoxin intoxications in the emergency department of a tertiary hospital.Material and Methods Single-centre retrospective study included all adult patients attending the emergency department with suspected digoxin intoxication between February 2021 and June 2025 in a tertiary hospital. Data collected included demographic (age, sex) and clinical data (diagnosis, digoxin blood levels, use of anti-digoxin antibodies, treatment changes at discharge, and 30-day readmissions). Proportions were compared using Chi-square tests, and means were compared using Student’s t-tests.Results A total of 46 patients were included, with a mean age of 84.7 years; 38 (82.6%) were women and 8 (17.4%) were men. Mean age in women was 85,3±6.9 years and in men 81,4±8,9 years (p=0.174). Mean digoxin blood levels (nmol/L) were 3.6±1.8 in women and 3.5±2.1 in men (p=0.890). 24 women (63.2%) and 4 men (50.0%) had confirmed digoxin intoxications with blood levels over 2.6 nmol/L (p=0.487). Three women (7.9%) and one man (11.1%) (p=0.767) required anti-digoxin antibodies administration. At hospital discharge, 26 (68.4%) women and 5 (62.5%) men required treatment suspension (p=0.746). Only 5 patients (all women, 13.2%) required readmission.Conclusion and Relevance This study provides real-world evidence on sex differences in digoxin intoxications in a tertiary hospital. Although most cases occurred in women, no statistically significant differences were observed in digoxin levels, treatment adjustments, or antibody use. Nevertheless, there was a trend toward higher readmission rates among women, suggesting possible sex-related factors influencing follow-up outcomes. Larger studies are warranted to confirm these findings and better characterise sex-based differences in digoxin toxicity.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital De Sant Pau, Pharmacy Department, Barcelona, Spain"
      ],
      "name": "A Domínguez Navarro"
    },
    {
      "affiliations": [
        "Hospital De Sant Pau, Pharmacy Department, Barcelona, Spain"
      ],
      "name": "M Fuentes-Herrero"
    },
    {
      "affiliations": [
        "Hospital De Sant Pau, Pharmacy Department, Barcelona, Spain"
      ],
      "name": "P Amorós-Reboredo"
    },
    {
      "affiliations": [
        "Hospital De Sant Pau, Pharmacy Department, Barcelona, Spain"
      ],
      "name": "A Plaza-Diaz"
    },
    {
      "affiliations": [
        "Hospital De Sant Pau, Pharmacy Department, Barcelona, Spain"
      ],
      "name": "M Panisello Cardona"
    },
    {
      "affiliations": [
        "Universitat Autònoma De Barcelona, Pharmacology Department, Barcelona, Spain"
      ],
      "name": "C Marín De La Bárcena Grau"
    },
    {
      "affiliations": [
        "Hospital De Sant Pau, Pharmacy Department, Barcelona, Spain"
      ],
      "name": "J Ruiz-Ramos"
    }
  ],
  "title": "4CPS-210 Analysis of suspected digoxin toxicity with a gender perspective",
  "uid": "22a72e74-6c0d-5eea-9a7b-b832d720f3c3"
}