Popular
drug ups death risk in heart patients
London, May 5 A large study involving over 320,000 patients has found that a
drug that has been used worldwide for centuries to treat heart disease, might
contribute to an increase in deaths in patients with heart problems.
In this largest-ever review of the effects of digoxin, the researchers found
that the drug is harmful for patients with atrial fibrillation or AF (an
irregular heartbeat) and also in patients with congestive heart failure or CHF
(when the heart's function as a pump is impaired).
"Our analysis, together with evidence from other studies, all point in the
same direction: there is harm associated with the use of digoxin," said
lead researchers Stefan Hohnloser, professor of cardiology at the J.W. Goethe
University in Frankfurt, Germany.
Digoxin is extracted from the foxglove plant (digitalis) and it helps the heart
beat more strongly and with a more regular rhythm. It is commonly used in
patients with AF and CHF.
However, it can be difficult to use successfully as there is a narrow dose
range at which it is effective and beyond which it can be dangerous.
Currently, its use is recommended in guidelines from the US and from the
European Society of Cardiology for patients with heart failure and problems
with control of the heart's rhythm.
"These recommendations reflect the highly unsatisfactory data basis on
which to judge the supposed benefits of digoxin," the authors of the
current study wrote.
The researchers conducted a systematic review and meta-analysis of all studies
published in peer-reviewed journals between 1993-2014 that looked at the
effects of digoxin on death from any cause in AF and CHF patients.
They identified 19 relevant studies that included a total of 326,426 patients
(235,047 AF and 91,379 CHF patients).
They found that among patients who were treated with digoxin, there was an
overall 21 percent increased risk of death from any cause compared to patients
who were not receiving this treatment.
When they looked at the group of AF patients and the group of CHF patients
separately, digoxin was associated with a 29 percent and 14 percent increased
risk of death from any cause respectively, when compared to patients not
receiving the drug.
"Digoxin has been used for decades and even now it is used in
approximately one in three AF patients... My personal feeling is that the time
of digoxin - particularly as a heart rate-controlling drug in AF - is over. But
this needs to be tested in appropriately designed studies," Hohnloser
pointed out.
The findings were detailed in the European Heart Journal.
