Heart Medication Associated With Higher Death Rate

Digoxin to treat atrial fibrillation may increase risk of death

(RxWiki News) A variety of medicines can treat irregular heart rhythm. But one of those medicines may increase the risk of death.

Irregular heart rhythm, while largely treatable, can lead to chest pain and other serious medical issues like congestive heart failure. Doctors can treat it by resetting the heart rate with electrical stimulation or one of several prescription medicines.

New research suggests digoxin — a common medicine to treat irregular heart rhythm — may raise patients' risk of death.

"Discuss medicine side effects and risks with your cardiologist."

The study was written by Mintu Turakhia, MD, MAS, of the Veterans Affairs Palo Alto Health Care System and the Stanford University School of Medicine in Stanford, CA, and colleagues.

The study authors set out to examine the connection between treatment with the prescription medicine digoxin (brand names Digox or Lanoxin) and death in patients with atrial fibrillation (AF).

Digoxin is generally taken once a day by mouth and used to treat AF, which is marked by rapid, irregular heart rate.

Dr. Turakhia and team reviewed Veterans Affairs medical records for 122,465 patients diagnosed with AF between 2004 and 2008.

The study participants were 72.1 years old on average, and 98.4 percent were men. Of that group, 28,679 patients (23.4 percent) received digoxin.

Of the group that received digoxin, the study authors found 95 deaths per 1,000 patients. In the group with untreated AF, there were 67 deaths per 1,000 patients.

After adjusting for other variables, the researchers concluded that digoxin treatment was 1.26 times more likely to result in death than leaving AF untreated.

"The take-home point is to question whether people should really be on this drug," Dr. Turakhia said in a press release.

"We are not asserting this drug should never be used," he said. "However, in light of the many other drugs that can be used to slow down the heart rate in [AF], patients and providers need to ask whether digoxin should be the treatment of choice when there are other, safer drugs.”

The study was published online Aug. 11 in the peer-reviewed Journal of the American College of Cardiology.

Funding was provided by Veterans Health Services Research and Development, the American Heart Association, the National Institute for Diabetes and Digestive and Kidney Diseases and the Center for Health Care Evaluation/Center for Innovation to Implementation.

One study author disclosed serving on advisory boards for medicine manufacturers and other private companies.

Review Date: 
August 11, 2014