Digoxin Ups Death Risk in Newly Diagnosed A-Fib Patients
(HealthDay News) — Among patients with newly diagnosed atrial fibrillation (AF), the use of digoxin is associated with increased risk of death, according to research published in the August 19 issue of the Journal of the American College of Cardiology.
Mintu P. Turakhia, MD, from Stanford University in California, and colleagues analyzed data from the United States Department of Veterans Affairs health care system for 122,465 patients (98.4% male; mean age, 72.1 ± 10.3 years), including 28,679 patients who received digoxin. The authors sought to evaluate the association between digoxin use and mortality.
The researchers found that digoxin-treated patients, compared with untreated patients, had higher cumulative mortality rates (95 vs. 67 per 1,000 person-years; P<0.001). Even after accounting for drug adherence, digoxin use was found to be independently associated with mortality after multivariable adjustment (hazard ratio, 1.26; P<0.001) and propensity matching (hazard ratio, 1.21; P<0.001). Potential modifiers, including age, sex, heart failure, kidney function, and concomitant use of amiodarone, beta-blockers, or warfarin, did not affect the risk of death.
"We are not asserting this drug should never be used," a coauthor said in a statement. "However, in light of the many other drugs that can be used to slow down the heart rate in atrial fibrillation, patients and providers need to ask whether digoxin should be the treatment of choice when there are other, safer drugs."
One author disclosed financial ties to pharmaceutical and biomedical companies.