Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased Mortality
Introduction. Digoxin is used to control ventricular rate in atrial fibrillation (AF). There is conflicting evidence regarding safety of digoxin. We aimed to evaluate the risk of mortality with digoxin use in patients with AF using meta-analyses. Methods. PubMed was searched for studies comparing ou...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2015/314041 |
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| author | Surbhi Chamaria Anand M. Desai Pratap C. Reddy Brian Olshansky Paari Dominic |
| author_facet | Surbhi Chamaria Anand M. Desai Pratap C. Reddy Brian Olshansky Paari Dominic |
| author_sort | Surbhi Chamaria |
| collection | DOAJ |
| description | Introduction. Digoxin is used to control ventricular rate in atrial fibrillation (AF). There is conflicting evidence regarding safety of digoxin. We aimed to evaluate the risk of mortality with digoxin use in patients with AF using meta-analyses. Methods. PubMed was searched for studies comparing outcomes of patients with AF taking digoxin versus no digoxin, with or without heart failure (HF). Studies were excluded if they reported only a point estimate of mortality, duplicated patient populations, and/or did not report adjusted hazard ratios (HR). The primary endpoint was all-cause mortality. Adjusted HRs were combined using generic inverse variance and log hazard ratios. A multivariate metaregression model was used to explore heterogeneity in studies. Results. Twelve studies with 321,944 patients were included in the meta-analysis. In all AF patients, irrespective of heart failure status, digoxin is associated with increased all-cause mortality (HR [1.23], 95% confidence interval [CI] 1.16–1.31). However, digoxin is not associated with increased mortality in patients with AF and HF (HR [1.08], 95% CI 0.99–1.18). In AF patients without HF digoxin is associated with increased all-cause mortality (HR [1.38], 95% CI 1.12–1.71). Conclusion. In patients with AF and HF, digoxin use is not associated with an increased risk of all-cause mortality when used for rate control. |
| format | Article |
| id | doaj-art-e620e93552fb4a67b12b90a914d1609c |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-e620e93552fb4a67b12b90a914d1609c2025-02-03T01:33:17ZengWileyCardiology Research and Practice2090-80162090-05972015-01-01201510.1155/2015/314041314041Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased MortalitySurbhi Chamaria0Anand M. Desai1Pratap C. Reddy2Brian Olshansky3Paari Dominic4Division of Cardiology and Center for Cardiovascular Diseases and Science, LSU Health Science Center, Shreveport, LA 71103, USADivision of Cardiology and Center for Cardiovascular Diseases and Science, LSU Health Science Center, Shreveport, LA 71103, USADivision of Cardiology and Center for Cardiovascular Diseases and Science, LSU Health Science Center, Shreveport, LA 71103, USADivision of Cardiovascular Medicine, University of Iowa, Iowa City, IA 52242, USADivision of Cardiology and Center for Cardiovascular Diseases and Science, LSU Health Science Center, Shreveport, LA 71103, USAIntroduction. Digoxin is used to control ventricular rate in atrial fibrillation (AF). There is conflicting evidence regarding safety of digoxin. We aimed to evaluate the risk of mortality with digoxin use in patients with AF using meta-analyses. Methods. PubMed was searched for studies comparing outcomes of patients with AF taking digoxin versus no digoxin, with or without heart failure (HF). Studies were excluded if they reported only a point estimate of mortality, duplicated patient populations, and/or did not report adjusted hazard ratios (HR). The primary endpoint was all-cause mortality. Adjusted HRs were combined using generic inverse variance and log hazard ratios. A multivariate metaregression model was used to explore heterogeneity in studies. Results. Twelve studies with 321,944 patients were included in the meta-analysis. In all AF patients, irrespective of heart failure status, digoxin is associated with increased all-cause mortality (HR [1.23], 95% confidence interval [CI] 1.16–1.31). However, digoxin is not associated with increased mortality in patients with AF and HF (HR [1.08], 95% CI 0.99–1.18). In AF patients without HF digoxin is associated with increased all-cause mortality (HR [1.38], 95% CI 1.12–1.71). Conclusion. In patients with AF and HF, digoxin use is not associated with an increased risk of all-cause mortality when used for rate control.http://dx.doi.org/10.1155/2015/314041 |
| spellingShingle | Surbhi Chamaria Anand M. Desai Pratap C. Reddy Brian Olshansky Paari Dominic Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased Mortality Cardiology Research and Practice |
| title | Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased Mortality |
| title_full | Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased Mortality |
| title_fullStr | Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased Mortality |
| title_full_unstemmed | Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased Mortality |
| title_short | Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased Mortality |
| title_sort | digoxin use to control ventricular rate in patients with atrial fibrillation and heart failure is not associated with increased mortality |
| url | http://dx.doi.org/10.1155/2015/314041 |
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