Heart Med Digoxin Tied to Higher Death Risk in Some
Increase seen in people with certain abnormal heart rhythms, study finds
Turakhia said that digoxin might benefit some patients. "Recent studies have shown that digoxin might keep people with heart failure out of the hospital," he said. "But most patients with atrial fibrillation don't have heart failure," he added.
The report was published online Aug. 11 in the Journal of the American College of Cardiology.
Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said, "Although digoxin has been used for decades to treat patients with atrial fibrillation, there has been very limited clinical trial data, and its safety and effectiveness for atrial fibrillation remains controversial."
Although a number of studies have suggested that digoxin may be associated with an increased risk of dying, the findings of these studies may be biased because digoxin is more likely used to treat patients with severe heart failure and for patients who cannot take beta-blockers or calcium channel blockers, he said.
The findings from this current study are also not definitive and raise more questions than they answer, Fonarow said. He thinks that clinical trials pitting digoxin against other treatments for atrial fibrillation are needed to settle the question.
In the meantime, Fonarow said, "patients with atrial fibrillation should not alter their medications without speaking to their cardiologist and carefully weighing the risks and benefits of the different treatment options."
For the study, Turakhia and colleagues used medical records from the U.S. Department of Veterans Affairs health care system between 2003 and 2008. They collected data on more than 120,000 people with newly diagnosed atrial fibrillation. Nearly all of them were men.
Nearly one-quarter of them were taking digoxin. Seventy percent of those taking the drug were still taking it after a year, the researchers noted.
Turakhia's team found that those taking digoxin were more than 20 percent more likely to die, compared with patients taking other drugs to control their atrial fibrillation.
The researcher took into account other factors, such as taking other drugs including beta-blockers, the heart rhythm drug amiodarone and the blood thinner warfarin. They also considered age and other medical conditions, such as kidney disease, heart attack or heart failure. However, the risk of death linked to digoxin remained the same, according to the study.