Internal Medicine News - Digoxin poses risk in women
Digoxin appears to raise the risk of death in stable heart failure, but only in women, according a post hoc analysis of data from a clinical trial.
This finding is based on “robust evidence” and “provides sufficient grounds for a reexamination of the use of digoxin therapy for women with heart failure,” said Saif S. Rathore, a public health specialist at Yale University, New Haven, and associates.
In 1997 the Digitalis Investigation Group reported that digoxin decreased the rate of hospitalization for worsening heart failure, based on a clinical trial involving nearly 8,000 patients at 302 clinical centers. The American College of Cardiology the American Heart Association, and the Heart Failure Society of America then issued guidelines strongly endorsing the use of digoxin in patients with heart failure.
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The Yale researchers decided to reassess the data because the study had enrolled four men for every woman. The post hoc analysis showed a 5.8% absolute difference between men and women in the drug’s effect on mortality. Digoxin raised the rate of death from any cause, death from cardiovascular causes, and death from worsening heart failure only in women (N. Engl. J. Med. 347[18]:1403-11, 2002).
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