Key result
Digoxin improved hemodynamics and symptoms in early trials, and withdrawing it from stable patients on diuretics and ACE inhibitors resulted in clinical deterioration.
Why the study?
Does digoxin improve clinical stability and symptoms in patients with heart failure and systolic dysfunction?
Does digoxin improve clinical stability and symptoms in patients with heart failure and systolic dysfunction?
Digoxin improves symptoms and maintains clinical stability in heart failure patients, though its effect on mortality in those receiving ACE inhibitors remains to be established.
Supports digoxin for symptoms and stability in systolic HF; leaves open mortality effects with ACE inhibitors.
In early placebo-controlled trials in patients with heart failure who were in sinus rhythm, digoxin improved hemodynamics, signs and symptoms of heart failure, and exercise capacity, and decreased functional deterioration and the need for pharmacologic cointervention. A more recent trial showed that withdrawing digoxin from patients who were clinically stable while receiving diuretics and angiotensin-converting enzyme (ACE) inhibitors often resulted in clinical deterioration, whereas continuing the agent maintained stability. Which patients should initially be treated with digoxin remains to be determined. The effects of digoxin on mortality in patients who are receiving ACE inhibitors must also be established.
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Kristin Williamson (1996) conducted a review in Heart failure with systolic dysfunction. Digoxin vs. Placebo / Withdrawal was evaluated. Digoxin improved hemodynamics and symptoms in early trials, and withdrawing it from stable patients on diuretics and ACE inhibitors resulted in clinical deterioration.
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