Digoxin Linked To High Death Rates
A new study by Kaiser Permanente researchers concludes that a common heart medicine could be deadly when prescribed to certain patients with atrial fibrillation.
According to the survey, the prescribing of digoxin to patients who have atrial fibrillation but have not been diagnosed with heart failure was associated with a much higher risk of hospitalization and death.
Digoxin, which is derived from the digitalis plant, has been used for decades to strengthen heart rhythms in patients and is branded as Digoz and Lanoxin. It has been routinely prescribed for patients who have an irregular heartbeat.
“Digoxin remains commonly used for rate control in atrial fibrillation, but very limited data exist to support this practice — mostly small, older clinical studies with very limited follow-up that did not assess the long-term effects of digoxin on mortality or hospitalization,” said Alan S. Go, M.D., senior author of the study and a research scientist at the Kaiser Division of Research in Oakland, Calif.
Kaiser studied more than 15,000 patients with atrial fibrillation treated at its facilities in Northern and Southern California between 2006 and 2009. About 18 percent of those were prescribed digoxin. It concluded that those prescribed digoxin had a 71 percent higher risk of dying compared to those atrial fibrillation patients who were not prescribed the drug. In additiont to the higher mortality rates, the risk of hospitalization rose 63 percent.
“Our findings suggest that the use of digoxin should be re-evaluated for the treatment of atrial fibrillation in contemporary clinical practice,” said study co-author Anthony Steimle, M.D., chief of cardiology at Kaiser's hospital in Santa Clara. “Given the other options available for heart rate control, digoxin should be used with caution in the management of atrial fibrillation, especially in the absence of symptomatic systolic heart failure.”
The study was published in the most recent edition of the journal Circulation: Arrhythmia and Electrophysiology.
