关于使用地高辛对心房颤动(简称房颤)或充血性心力衰竭(CHF)患者死亡率数据尚有争议，因此，德国学者对现有相关数据进行了一项系统回顾和荟萃分析。结果表明，地高辛可增加房颤患者和CHF患者的死亡风险，尤其是房颤患者。相关论文2015年5月4日在线发表于《欧洲心脏杂志》(Eur Heart J)。【郭艺芳教授：心衰患者还能使用地高辛治疗吗？】

        该荟萃分析检索了MEDLINE和COCHRANE数据库(1993–2014年)中评价地高辛对房颤或CHF患者全因死亡影响的英文文献。最终纳入了19篇报告中的326 426例患者。其中，9篇纳入的受试者为房颤患者，7篇为CHF患者，其余3篇为两种疾病均存在。

        结果基于校正死亡率结果的分析显示，地高辛与全因死亡相对风险增加有关[危险比(HR)1.21;P< 0.01]。

        对涉及235 047例房颤患者的文献亚组分析显示，与未接受糖苷治疗的受试者相比，地高辛可使死亡风险增加29%(HR 1.29)。在91379例心力衰竭患者中，地高辛相关死亡风险增加14% (HR 1.14)。

地高辛对全因死亡的影响

不同地高辛剂量对死亡的影响

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.