Tunstall-Pedoe H
Br Heart J. 1985 Sep;54(3):243-7. doi: 10.1136/hrt.54.3.243.
Data on monthly totals of cardiac deaths in England and Wales were examined in different ways to see whether there were any unexplained fluctuations in rates both at the time of an unplanned increase in the bioavailability and therefore the potency of the Lanoxin brand of digoxin in May 1972 and also when there was a coordinated increase in the bioavailability of other brands in October 1975. Despite advice to prescribers, dosages were not proportionately reduced in the 600 000 patients who were on treatment. Monthly totals of deaths from cardiac causes were high through the summer of 1972 but not at the end of 1975 and the excess in 1972 seems to be related to a cold summer. There was no evidence of a consistent or specific effect of changes in digoxin potency, either beneficial or harmful, on deaths from all cardiac causes or in specific subgroups in which digoxin treatment was likely to be most common. Although major changes in digoxin potency in England and Wales did not seem to produce a repeatable effect on death rates, data from other countries should also be examined for evidence of such an effect.
对英格兰和威尔士心脏死亡月度总数的数据进行了不同方式的检查，以查看在1972年5月地高辛的Lanoxin品牌生物利用度意外增加从而效力增强时，以及在1975年10月其他品牌生物利用度协同增加时，死亡率是否存在任何无法解释的波动。尽管已向开处方者提供了建议，但在接受治疗的60万名患者中，剂量并未按比例减少。1972年整个夏季心脏原因导致的死亡月度总数很高，但1975年底并非如此，1972年的超额死亡似乎与夏季寒冷有关。没有证据表明地高辛效力的变化对所有心脏原因导致的死亡或地高辛治疗可能最常见的特定亚组产生一致或特定的影响，无论是有益还是有害的影响。尽管英格兰和威尔士地高辛效力的重大变化似乎未对死亡率产生可重复的影响，但也应检查其他国家的数据以寻找此类影响的证据。
