An extensive meta-analysis of nineteen studies that was carried out by the German Goethe University showed that digoxin, a first choice drug used in the treatment of heart failure, actually increases the risk of death. A total of 235,000 cases of heart failure was taken into account in this study.
Though digoxin is known for its potential benefits, it is notorious for its dangerous complications. The drug is difficult to control and its effect is unpredictable. Distinguishing between side effects, asking for lowering the dose, and worsening of the disease, asking for raising the dose, is difficult. Long term complications include toxicity, due to a slow excretion by the human body.
Although this study seems to be reliable due to an enormous amount of study subjects, there still are many uncertainties. For example, this study was not a randomized control study, which means that the drug was not randomly prescribed for a part of the studied subjects. Results are not corrected for reasons for not taking the drug.It is likely that the drug was refused by patients who had a mild form of heart failure, whereas patients with a more severe form were more willing to accept the risks of taking the drug. The latter group would have had a higher a priori risk of fatal heart disease. Secondly, the average follow up duration was only 2,5 years. Follow up for a longer period of time could point out something different.
Digoxin is prescribed to millions of people. If digoxin appears to reduce life expectancy in heart disease patients, its position in future health care should be considered. Nevertheless, more research is needed to confirm of refuting the claim that digoxin has a bad influence on prognosis.