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Study: Digoxin Therapy Linked to Increased Risk of Death in Heart Failure Patients

New data contradict previous findings (September 20)

Digoxin, a digitalis-derived drug commonly used to treat heart conditions, was associated with a 72% higher rate of death among adults with newly diagnosed systolic heart failure, according to a Kaiser Permanente study published in Circulation: Cardiovascular Quality and Outcomes.

“These findings suggest that the use of digoxin should be re-evaluated for the treatment of systolic heart failure in contemporary clinical practice,” said senior author Alan S. Go, MD.

The results of the new study contrast with the findings of a randomized trial by the Digitalis Investigation Group conducted between 1991 and 1993, which showed that digoxin did not lower mortality in patients with systolic heart failure or with a malfunction in the way the left ventricle of the heart pumps blood. Following the publication of that study, professional societies issued clinical guidelines endorsing the use of digoxin for patients with systolic dysfunction.

The new study was conducted among 2,891 adults within Kaiser Permanente in Northern California who were diagnosed with systolic heart failure between 2006 and 2008 and who had no prior digoxin use. Eighteen percent of the participants initiated digoxin during the study period.

Researchers followed the patients through December 31, 2010, to evaluate the effectiveness and safety of digoxin therapy. They found that digoxin use was associated with higher mortality but no significant difference in the risk of heart-failure hospitalization.

A total of 801 deaths occurred — 737 off digoxin and 64 on digoxin. After adjustment for potential confounders, digoxin use was associated with a 72% higher relative mortality rate.

There were 1,723 hospitalizations for heart failure overall — 1,596 off digoxin, 127 on digoxin. However, after adjustment for potential confounders, digoxin use was not significantly associated with hospitalization for heart failure.

Source: EurekAlert; September 20, 2013.

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