關於使用地高辛對心房顫動(簡稱房顫)或充血性心力衰竭(CHF)患者死亡率數據尚有爭議，因此，德國學者對現有相關數據進行了一項係統回顧和薈萃分析。結果表明，地高辛可增加房顫患者和CHF患者的死亡風險，尤其是房顫患者。相關論文2015年5月4日在線發表於《歐洲心髒雜誌》(Eur Heart J)。【郭藝芳教授：心衰患者還能使用地高辛治療嗎？】

該薈萃分析檢索了MEDLINE和COCHRANE數據庫(1993–2014年)中評價地高辛對房顫或CHF患者全因死亡影響的英文文獻。最終納入了19篇報告中的326 426例患者。其中，9篇納入的受試者為房顫患者，7篇為CHF患者，其餘3篇為兩種疾病均存在。

結果基於校正死亡率結果的分析顯示，地高辛與全因死亡相對風險增加有關[危險比(HR)1.21;P< 0.01]。

對涉及235 047例房顫患者的文獻亞組分析顯示，與未接受糖苷治療的受試者相比，地高辛可使死亡風險增加29%(HR 1.29)。在91379例心力衰竭患者中，地高辛相關死亡風險增加14% (HR 1.14)。

地高辛對全因死亡的影響

不同地高辛劑量對死亡的影響

原文

Digoxin-associated mortality: a systematic review and meta-analysis of the literature

Mate Vamos , Julia W. Erath , Stefan H. HohnloserEur Heart J (2015) DOI: http://dx.doi.org/10.1093/eurheartj/ehv143 First published online: 4 May 2015 (8 pages)

There are conflicting data regarding the effect of digoxin use on mortality in patients with atrial fibrillation (AF) or with congestive heart failure (CHF).

The aim of this meta-analysis was to provide detailed analysis of the currently available study reports. We performed a MEDLINE and a COCHRANE search (1993–2014) of the English literature dealing with the effects of digoxin on all-cause-mortality in subjects with AF or CHF.

Only full-sized articles published in peer-reviewed journals were considered for this meta-analysis. A total of 19 reports were identified. Nine reports dealt with AF patients, seven with patients suffering from CHF, and three with both clinical conditions.

Based on the analysis of adjusted mortality results of all 19 studies comprising 326 426 patients, digoxin use was associated with an increased relative risk of all-cause mortality [Hazard ratio (HR) 1.21, 95% confidence interval (CI), 1.07 to 1.38, P < 0.01]. Compared with subjects not receiving glycosides, digoxin was associated with a 29% increased mortality risk (HR 1.29; 95% CI, 1.21 to 1.39) in the subgroup of publications comprising 235 047 AF patients. Among 91379 heart failure patients, digoxin-associated mortality risk increased by 14% (HR 1.14, 95% CI, 1.06 to 1.22).

The present systematic review and meta-analysis of all available data sources suggest that digoxin use is associated with an increased mortality risk, particularly among patients suffering from AF.