Jodi Whitaker

By

College: Medicine

UK Study Finds Commonly Used Heart Disease Drug Increases Deaths in Atrial Fibrillation Patients

Published: Nov 28, 2012

 

LEXINGTON, Ky. (Nov. 27, 2012) -- Digoxin, a drug widely used to treat heart disease, increases the possibility of death when used by patients with a common heart rhythm problem − atrial fibrillation (AF), according to new study findings by University of Kentucky researchers. The results have been published in the prestigious European Heart Journal, and raises serious concerns about the expansive use of this long-standing heart medication in patients with AF.

 

UK researchers led by Dr. Samy Claude Elayi, associate professor of medicine at UK HealthCare's Gill Heart Institute, analyzed data from 4,060 AF patients enrolled in the landmark Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial. This analysis was intended to determine the relationship between digoxin and deaths in this group of patients with atrial fibrillation, and whether digoxin was directly responsible for some deaths.

 

“These findings raise important concerns about the safety of digoxin, one of the oldest and most controversial heart drugs,” said Dr. Steven E. Nissen, chair of cardiovascular medicine at the Cleveland Clinic. "Although considered obsolete by some authorities, digoxin is still widely used. A thorough review by the FDA is warranted to determine whether regulatory action is needed, including stronger warnings about the use of digoxin in patients with atrial fibrillation. “


Digoxin is extracted from the foxglove plant and it helps the heart beat more strongly, and at a slower heart rate. It is commonly used in AF patients and in patients with heart failure. However, it can be problematic to use successfully as there is a narrow dose range at which it is effective, and beyond which it can be dangerous.

 

Though digoxin has been used by physicians treating AF for decades, until now, there has been limited evidence demonstrating the effect of digoxin in patients with this condition. “Digoxin in AF patients has hardly been studied,” said Elayi. “The main prospective randomised controlled trials available with digoxin were performed in patients with heart failure and sinus rhythm, and routinely excluded AF patients.”

 

The results of the analysis found that digoxin was associated with a 41 percent increase in deaths from any cause after controlling for other medications and risk factors. An increase in deaths occurred regardless of gender or the presence or absence of underlying heart failure. Digoxin was also associated with a 35 percent increase in deaths from cardiovascular causes, and a 61 percent increase in deaths from arrhythmias or problems with the rate or rhythm of the heartbeat.

 

"Within five years of use, one additional AF patient out of six taking digoxin − compared to those not on digoxin in the AFFIRM trial− will die from any cause," Elayi said. "One additional patient out of eight will die from cardiovascular causes, and one additional patient out of 16 will die from arrhythmias.

 

“This study calls into question the widespread use of digoxin in patients with AF, particularly when used for controlling AF rate in a similar way as in the AFFIRM trial," Elayi said. “These findings suggest that physicians should try to control a patient’s heart rate by using alternatives such as beta-blockers or calcium blockers ,as a first line treatment.

 

"If digoxin is used, prescribers should use a low dose with careful clinical follow up, evaluate potential drug interactions when starting new medications, and monitor digoxin levels."

 

In addition, patients should also be aware of potential toxicity and see their physicians immediately in specific clinical situations, he said. For instance, if they experience increasing nausea, vomiting, palpitations or syncope, as those may precede arrhythmic death, Elayi added.

 

The researchers say that the mechanism by which digoxin increases deaths among patients is unclear. Deaths from classic cardiovascular causes - whether or not they are due to arrhythmia - can partly but not entirely explain it. This suggests there must be some additional mechanism that remains to be identified, said Elayi.

 

“Our study underscores the importance of reassessing the role of digoxin in the contemporary management of AF in patients with or without HF,” concluded the authors in their paper.

“There is a need for further studies of the drug’s use, particularly in systolic heart failure patients and AF – patients that would, in theory, benefit the most from digoxin.”

 

The full research paper is available at http://www.oxfordjournals.org/our_journals/eurheartj/press_releases/freepdf/prpaper.pdf

 

 

 Media Contact: Jodi Whitaker at (859) 257-5307

_dsc1296_2.jpg
March
1
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Sun
2
Wildcat Wellness: Expressions (Creative Stress Relief)
Resume & Cover Letters that Work
Mon
3
Wildcat Wellness: Relaxation
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Grad Salute
2nd Annual UK Work-Life Summer Camps Fair
UK Elder Care Lunch & Learn - Keeping Your Brain Healthy
Successful Networking & Job Search
Guest Lecture
Documentary Screening: "Forgotten Wars, Forgotten Victims"
Bangladeshi Garment Worker Speak Out
A Reading by Nic Brown
CatWatch Party #3
Tue
4
LNFS Presents: The Mighty Ducks
Wildcat Wellness: Meditation
Internship Info Session
Grad Salute
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Brazilian Conversation Hour
Art Therapy Table
OUTspoken with J Mase III
CANCELED: Appalachian Forum with Crystal Wilkinson entitled: Birds of Opulence: Black Women, Madness, and Resilience in Appalachia
Wed
5
LNFS Presents: Typeface
LNFS Presents: Space Jam
Grad Salute
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Wildcat Wellness: Healthy Habits
Food for Hope
Thu
6
LNFS Presents: A Girl Walks Home Alone at Night
LNFS Presents: Pokémon: The First Movie
Cultural Coffee Hour
Grad Salute
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Japan Today
Fri
7
Free Saturday Swing Dance Lessons
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Karnival Around The World
Graduate & Professional School Prep:KAPLAN Free Practice Test for MCAT and LSAT
PharmD Open House
Sat
8
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Sun
9
Midterm of 2015 Spring Semester
Wildcat Wellness: Expressions (Creative Stress Relief)
GUEST LECTURE
Appalachian Forum with Rebecca Klenk, Topic: Global Uttarakhand: Development, Neoliberalism and Social Justice in Himalayan India
Ballroom Thieves
Mon
10
Wildcat Wellness: Relaxation
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Job Club: Staying Positive During A Job Search
Massage on the Go #2
Tue
11
LNFS Presents: Only Lovers Left Alive
Wildcat Wellness: Meditation
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Brazilian Conversation Hour
Jin Shin Jyutsu Self-Help Class
Leadership Assessment
#TrendingTopics: Immunization
True Songs
Wed
12
LNFS Presents: Into the Woods
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Wildcat Wellness: Healthy Habits
Free Spring Break Shuttle to Blue Grass Airport
LNFS Presents: Waiting for 'Superman'
Thu
13
LNFS Presents: Vertigo
Cultural Coffee Hour
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Free Spring Break Shuttle to Blue Grass Airport
LNFS Presents: Trainspotting
Fri
14
Free Saturday Swing Dance Lessons
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Sat
15
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Sun
16
Spring 2015 Spring Vacation
Mon
17
Spring 2015 Spring Vacation
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Tue
18
Spring 2015 Spring Vacation
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Wed
19
Spring 2015 Spring Vacation
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Thu
20
Spring 2015 Spring Vacation
Cultural Coffee Hour
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Plating Design Demonstration with Dan Wu
Fri
21
Spring 2015 Spring Vacation
Free Saturday Swing Dance Lessons
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Sat
22
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Sun
23
Wildcat Wellness: Expressions (Creative Stress Relief)
"Thrive: The Kentucky Wine Tradition" Documentary Screening
Mon
24
Wildcat Wellness: Relaxation
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Job Club: A Snapshot of the Central Kentucky Labor Market
Career & Major Exploration Session @ 1 p.m.
Career & Major Exploration Session @ 2 p.m.
Career & Major Exploration Session @ 3 p.m.
Kentucky Teacher's Network Career Fair
Tue
25
LNFS Presents: Rear Window
Wildcat Wellness: Meditation
Internship Info Session
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Brazilian Conversation Hour
Healthy Smoothie Demonstration
Cultural Diversity Festival: Ten Thousand Villages
Virtual Dementia Tour
Career & Major Exploration Session @ 1 p.m.
Healthy Smoothie Demonstration
Career & Major Exploration Session @ 2 p.m.
Career & Major Exploration Session @ 3 p.m.
Barred for Life: A Conversation on Mass Incarceration
Women of the World: Rosario Dawson
Wed
26
LNFS Presents: The Imitation Game
LNFS Presents: Blade Runner
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Wildcat Wellness: Healthy Habits
Student & Employer Mixer
Young Artists Exhibit Reception
Thu
27
LNFS Presents: Psycho
LNFS Presents: The Life Aquatic with Steve Zissou
Cultural Coffee Hour
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
UK Woman's Club Craft and Bake Sale
Northeast Florida’s Late Archaic Mortuary Mounds: Memory, Community, and Environment.
Fri
28
Free Saturday Swing Dance Lessons
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Sat
29
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
Lion King Trip
The Voice of Lexington Chinese Singing Competetion
Sun
30
Wildcat Wellness: Expressions (Creative Stress Relief)
Mon
31
Wildcat Wellness: Relaxation
Tanya Habjouqa: Recent Photographs
Edward Troye: Theme & Variation
Same Difference: Michelle Grabner, Simone Leigh & Russell Maltz
Lexington Tattoo Project
A Reading by Jim Gavin
Tue
 
 
 
 
Mar 31
Wildcat Wellness: Relaxation 03/31/2015

Wed, 04/01/2015

Repeats every week until Thu Apr 30 2015 except Wed Mar 18 2015.
Wed, 04/01/2015

Repeats every week until Wed May 06 2015 except Wed Mar 18 2015.
Wed, 04/01/2015

Repeats every day on January, February, March, April every Tuesday and every Wednesday and every Thursday and every Friday and every Saturday and on the first Sunday until Sun Apr 12 2015 except Mon Jan 12 2015, Mon Jan 26 2015, Mon Feb 02 2015, Mon Feb 09 2015, Mon Feb 16 2015, Mon Feb 23 2015, Mon Mar 02 2015, Mon Mar 09 2015, Mon Mar 16 2015, Mon Mar 23 2015, Mon Mar 30 2015, Mon Apr 06 2015.
Wed, 04/01/2015

Reset Page