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[Optimization of digitalis therapy in clinical practice]

A I Dyadyk1, V A Efremenko1, T E Kugler1

  • 1"M. Gorky Donetsk National Medical University" of the Ukraine Ministry of Health Care.

Kardiologiia
|June 13, 2018
PubMed

Insights

Cardiac glycosides use has declined despite conflicting evidence on digoxin

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Cardiac glycosides, including digoxin, have seen reduced use in heart failure patients.
  • Published studies present contradictory findings regarding digoxin's efficacy and safety.
  • This has led to uncertainty about its role in managing heart failure with sinus rhythm and atrial fibrillation.

Purpose of the Study:

  • To impartially analyze existing literature on cardiac glycosides.
  • To reflect modern understanding of cardiac glycoside mechanisms and pharmacokinetics.
  • To explore strategies for optimizing digitalis therapy in clinical practice.

Main Methods:

  • Systematic review and meta-analysis of published studies.
  • Analysis of pharmacokinetic and pharmacodynamic data.
  • Evaluation of clinical trial outcomes related to digoxin use.

Main Results:

  • Evidence remains divided on whether digoxin improves outcomes or increases mortality/hospitalizations.
  • Pharmacokinetic variability influences digoxin's therapeutic window.
  • Optimizing digitalis therapy requires careful patient selection and monitoring.

Conclusions:

  • A balanced perspective on digoxin's benefits and risks is necessary.
  • Further research may clarify optimal use cases for digitalis in heart failure.
  • Personalized approaches to digitalis therapy are crucial for effective patient management.

Keywords:
cardiac glycosides, digitalis, digoxin, heart failure, atrial fibrillation, lethality, hospitalizations

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