Dialysis Patients and CHF Patients on Digoxin Have Increased Death Risk

According to the findings of a new study, the heart drug, digoxin, may increase the risk of death when given to patients with atrial fibrillation.

Researchers from the United Kingdom published a study this week in the European Heart Journal, raising serious questions about the potential side effects of digoxin and the effectiveness of the heart medication.

Digoxin has been used for many years to treat patients with atrial fibrillation. The findings in this new study suggest that rather than helping these patients, the results may be serious and potentially fatal for some patients.

Researchers reviewed data from 4,060 atrial fibrillation patients, who participated in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM)

trial. According to the findings, there was a 41 percent increase in death among patients who were given the drug. That included a 35 percent increase in the rate of death due to cardiovascular causes of any kind, and a 61 percent increase in the rate of death attributed to heart rhythm problems.

Digoxin is commonly used to treat congestive heart failure (CHF), abnormal heart rhythms, atrial flutter and atrial fibrillation. This medication is dose-specific…if too little is prescribed, it can be ineffective and if too much is prescribed, it can cause digoxin overdose, resulting in serious and potentially life-threatening digitalis toxicity.

For patients with kidney disease on dialysis, the widely used heart medicine, digoxin may lead to an increased risk of premature death, according to a study appearing in an upcoming issue of the Journal of American Society of Nephrology.

Researchers monitored approximately 120,000 dialysis patients from 1,800 clinics across the country, for up to four years. “We were surprised to find that digoxin use increased death risk in dialysis patients, especially in patients on higher doses,” said Kevin Chan, M.D., MSci, Fresenius Medical Care North America, Waltham, MA.

The risk of death was 28 percent higher for dialysis patients who were taking digoxin. The increase in risk was greater for patients with higher levels of digoxin in their blood and in patients who had lower serum potassium levels, which is a well-known factor that contributes to digoxin toxicity.

Four percent of dialysis patients in the study were taking digoxin. “Although digoxin has been prescribed by doctors for over 200 years, widespread monitoring studies have not been conducted to examine the penetration, effectiveness, and safety of the drug among patients on dialysis,” says Dr. Chan.

Dr. Chan emphasized that these findings cannot be considered conclusive and that “further research is needed to outline how and if digoxin can be safely prescribed in patients on hemodialysis.”

Dr. Chan further stated, “Overall, we suggest caution for digoxin use in the general hemodialysis population, given its prescription was associated with increased mortality in this study.”

It is recommended that in the meantime, doctors, patients and healthcare providers should reconsider the benefits of digoxin when alternative treatments are available for heart disease in patients starting dialysis.  Dr. Chan did suggest that, “for patients who remain on digoxin, vigilant monitoring of digoxin and potassium blood levels can minimize the drug’s possible side effects.”

It is important to report any side effects to your doctor.

Contact our Gacovino Lake attorneys at 1-800-246-HURT (4878).

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