The present systematic review and meta- analysis of all available data sources suggest that digoxin use is associated with an increased mortality risk , particularly among patients suffering from AF
There are conflicting data regarding the effect of digoxin use on mortality in patients with atrial fibrillation ( AF ) or with congestive heart failure ( CHF ) .
The aim of this meta- analysis was to provide detailed analysis of the currently available study reports .
Digitalis: a dangerous drug in atrial fibrillation? An analysis of the SPORTIF III and V data
Objective : In heart failure , digitalis increases exercise capacity and reduces morbidity , but has no effect on survival . This raises the suspicion that the inotropic benefits of digitalis may be counteracted by serious adverse effects . Patients with atrial fibrillation ( AF ) were studied to clarify this . Design : In the Stroke Prevention using an ORal Thrombin Inhibitor in atrial Fibrillation ( SPORTIF ) III and V studies , 7329 patients with AF at moderate-to-high risk were r and omised to preventive treatment of thromboembolism , either with warfarin or the oral direct thrombin inhibitor ximelagatran . The survival of users and non-users of digitalis was investigated . Results : At baseline , 53.4 % of the study population used digitalis , and these patients had a higher mortality than non-users ( 255/3911 ( 6.5 % ) vs 141/3418 ( 4.1 % ) , p<0.001 ; hazard ratio ( HR ) = 1.58 ( 95 % CI 1.29 to 1.94 ) ) . Digitalis users also had more baseline risk factors . After multivariate risk factor adjustment , the increased mortality persisted ( p<0.001 ; HR = 1.53 ( 95 % CI 1.22 to 1.92 vs 1.23 to 1.92 ) ) . Conclusions : The results suggest that digitalis , like other inotropic drugs , may increase mortality . This may be concealed in heart failure , but be revealed in patients with AF , who need the rate-reducing effect of digitalis , but do not benefit much from an increased inotropy . Cautious interpretation of the data is m and atory since the patients were not r and omised with respect to digitalis use
The present systematic review and meta- analysis of all available data sources suggest that digoxin use is associated with an increased mortality risk , particularly among patients suffering from AF
There are conflicting data regarding the effect of digoxin use on mortality in patients with atrial fibrillation ( AF ) or with congestive heart failure ( CHF ) .
The aim of this meta- analysis was to provide detailed analysis of the currently available study reports .