（英文原文）Digoxin-associated mortality: a systematic review and meta-analysisof the literature
There are conflicting data regarding theeffect of digoxin use on mortality in patients with atrial fibrillation (AF) orwith congestive heart failure (CHF). The aim of this meta-analysis was toprovide detailed analysis of the currently available study reports.
Weperformed a MEDLINE and a COCHRANE search (1993–2014) of the English literaturedealing with the effects of digoxin on all-cause-mortality in subjects with AFor CHF. Only full-sized articles published in peer-reviewed journals wereconsidered for this meta-analysis.
A total of 19 reports were identified. Ninereports dealt with AF patients, seven with patients suffering from CHF, andthree with both clinical conditions. Based on the analysis of adjustedmortality results of all 19 studies comprising 326 426 patients, digoxin usewas associated with an increased relative risk of all-cause mortality [Hazardratio (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 91.379 heart failure patients, digoxin-associated mortality riskincreased by 14% (HR 1.14, 95% CI, 1.06 to 1.22).
The present systematic review andmeta-analysis of all available data sources suggest that digoxin use isassociated with an increased mortality risk, particularly among patientssuffering from AF.
來源：ACC CV News Digest（May 5，2015）
地高辛可增加AF/CHF患者的死亡危險（中文摘要）
《歐洲心臟雜誌》5月4日在線發表研究顯示，地高辛可增加AF/CHF患者死亡危險，特別是房顫患者。
目前有關地高辛對房顫（AF）或充血性心衰（CHF）患者死亡影響的數據始終相互矛盾。這項薈萃分析對MEDLINE和COCHRANE（1993-2014年）有關地高辛對AF/CHF患者全因死亡影響的英文文獻進行檢索，並選擇在同行評議期刊上發表且樣本量足夠大的論文進行系統性回顧分析。
結果顯示，研究共納入19份研究報告。9份報告有關AF患者，7份報告有關CHF患者，另外3份報告同時涉及AF和CHF患者。最終研究對將近33萬例患者的校正後死亡結果進行分析：使用地高辛與全因死亡的相對危險增加相關（HR：1.21，P<0.01）。在AF亞組患者（23.5萬餘例）中，與未接受強心苷類藥物治療的患者相比，地高辛與死亡危險增加29%相關（HR：1.29）。在9.1萬餘例心衰患者中，使用地高辛與死亡危險增加14%相關（HR：1.14）。