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New study finds digoxin safe despite recent reports
Date:4/16/2013

CHICAGO --- A study published today in the European Heart Journal found no evidence that digoxin increases mortality in patients with atrial fibrillation (AF), the opposite of results just published by another group in the same journal analyzing the same data.

Older patients with AF also often have heart failure, and digoxin is approved to treat both conditions. AF is the most common kind of cardiac arrhythmia, an electrical malfunction that throws off the heart's rhythm and pumping rate. It may cause no symptoms or cause some patients to faint, but is seldom fatal. Heart failure, a gradual weakening of the heart's pumping strength, contributes to 280,000 U.S. deaths each year.

Both the earlier study that found digoxin increases mortality in AF and the study published today were re-analyses of data first collected as part of a clinical trial called Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) in 2002. The recent study that found digoxin increases mortality used an approach called "time-varying treatment," where patients who continued to receive digoxin over 3.4 years as part of the follow-up to AFFIRM were compared to those who did not.

According to current study, this "time-varying treatment" technique produced misleading results. By analyzing data from sicker patients who required continued digoxin treatment over the long term, it inadvertently introduced bias in its analysis of digoxin-related mortality.

"Digoxin is recommended by major national guidelines for use in heart failure and atrial fibrillation," said Mihai Gheorghiade, M.D., lead author of the study and professor of medicine and of surgery at Northwestern University Feinberg School of Medicine. "It is an inexpensive drug that is generally well tolerated at low doses, and there is no reason to question its usefulness or reassess its safety. We need to remember that although digoxin has been used for over two centuries, it
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Contact: Marla Paul
marla-paul@northwestern.edu
312-503-8928
Northwestern University
Source:Eurekalert

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