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Drug Raises Mortality Risk in Patients with AF

March 06, 2018

Digoxin use is associated with an increased risk of mortality among patients with atrial fibrillation (AF) with and without heart failure (HF), according to a recent study.

For their study, the researchers evaluated 17,987 patients with AF, comparing new digoxin users (n = 5824) with propensity-score-matched controls. The association between serum digoxin concentration and mortality was also assessed.

Ultimately, findings demonstrated that new digoxin users had a significantly higher risk of mortality (adjusted hazard ratio [HR] 1.78) and sudden death (adjusted HR 2.14) compared with controls.

Although no association was observed between baseline digoxin use and increased mortality risk (adjusted HR 1.09), a 56% higher risk of mortality was observed in patients with a serum digoxin concentration of at least 1.2 ng/ml (adjusted HR 1.56) compared with non-digoxin-users.

Furthermore, when assessed as a continuous variable, serum digoxin concentration was found to be associated with a 19% higher adjusted risk of mortality for each 0.5-ng/ml increase, regardless of HF status.

“In patients with AF taking digoxin, the risk of death was independently related to serum digoxin concentration and was highest in patients with concentrations [of at least 1.2 ng/ml],” the researchers concluded. “Initiating digoxin was independently associated with higher mortality in patients with AF, regardless of heart failure.”

—Christina Vogt

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