Heart drug not linked with raised risk of death
A new study challenges recent research showing that digoxin, a common heart drug, may raise the risk of an early death.
BMJ Group News
What do we know already?
Digoxin, which was developed from the foxglove plant, has been used to treat heart problems for more than 200 years. Today, it is prescribed mainly to treat heart failure and abnormal heart rhythms called atrial fibrillation and atrial flutter.
Although digoxin has a long history of helping with heart conditions, questions persist about how safe it is. Late last year researchers published a new analysis of data from a large study on digoxin and other treatments for atrial fibrillation. When researchers looked at people who took digoxin for at least three years, they found that people who took digoxin were more likely to have died than those who didn’t take this drug.
These findings were widely reported and raised concern about the safety of digoxin. However, some experts questioned whether the study might not have fully accounted for other factors that can affect a person’s chance of dying, such as whether they had heart failure. This could have explained the raised risk with digoxin.
Researchers have now looked again at the same group of people, using a different approach. From a pool of 2,706 people in the study, they put together 878 matching pairs of people who were similar in many important ways, including age, health, and the medicines they took. In each pair, one person had taken digoxin and the other had not. By closely matching people in the study in this way, the researchers aimed to minimise the effect that any other factors might have on the findings.
What does the new study say?
In the new analysis, people who took digoxin were no more likely to have died during the study than those who did not take the drug. Overall, 14 in every 100 people taking digoxin died, compared with 13 in every 100 not taking the drug. This difference was small enough that it could have been down to chance.
People who took digoxin were also no more likely to be hospitalised for any reason or to have episodes of irregular heartbeats (arrhythmias).
How reliable is the research?
This was a careful analysis that looked at 59 separate factors that might have affected people’s chance of dying during the study.
However, it’s worth noting that the data came from a study that wasn’t designed specifically to look at the safety of digoxin. Also, it would take a much bigger study than this one to show beyond a doubt that there is no risk with digoxin.
What does this mean for me?
If you have atrial fibrillation, this study suggests that taking digoxin will not increase your chance of dying early. This is reassuring news. Studies show that digoxin can be an effective treatment, either used on its own or combined with other drugs. However, it’s important to always take digoxin as directed and discuss any concerns with your doctor.