Digoxin and Heart Failure: Are We Clear Yet?

Abstract

The Digoxin Investigation Group trial has multiple flaws in the trial design for the findings to be universally applicable. Digoxin in low serum concentrations (0.5–0.9 ng/mL) has been shown to decrease mortality in heart failure patients. Multiple trials in different patient populations also show benefit of digoxin in heart failure patients, including women, elderly patients, renal disease patients, and patients with heart failure with preserved ejection fraction. Retrospective observational data linking digoxin use for treatment of atrial fibrillation to increased mortality is not seen in subgroups of randomized controlled trials or population registries. Digoxin remains a useful drug in the toolbox of physicians dealing with heart failure patients.