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[Is digoxin effective in the treatment of heart insufficiency in patients with sinus rhythm?]

O M Henriksen1, N Gadsbøll

  • 1H:S Bispebjerg Hospital, Medicinsk Center.

Ugeskrift for Laeger
|September 15, 1999
PubMed

Insights

Digitalis, specifically digoxin, remains a valuable treatment for heart failure in patients with sinus rhythm, reducing hospitalizations without impacting mortality. This finding is supported by major clinical trials like the DIG-trial.

Area of Science:

  • Cardiology
  • Pharmacology

Context:

  • Digitalis has been a long-standing treatment for heart failure since 1785.
  • Recent years have seen increased scrutiny regarding its use in patients with normal sinus rhythm.
  • The Digitalis Investigation Group (DIG) trial in 1997 provided significant data on digoxin's efficacy.

Purpose:

  • To evaluate the role of digoxin in managing heart failure patients, particularly those in sinus rhythm.
  • To assess the impact of digoxin on mortality and hospitalization rates in heart failure.

Summary:

  • The large-scale DIG trial randomized heart failure patients in sinus rhythm, all receiving ACE-inhibitors.
  • Digoxin did not demonstrate a significant effect on mortality rates.
  • However, digoxin use was associated with a significant reduction in hospitalizations for heart failure.

Impact:

  • Despite questions about its use in sinus rhythm, digoxin maintains a role in heart failure management.
  • Evidence from the DIG study, withdrawal trials (RADIANCE, PROVED), and other studies supports its continued use.
  • Digoxin is effective for heart failure patients with both atrial fibrillation and sinus rhythm.

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