Necessary cautions when considering digoxin in heart failure.

摘要

Digitalis is an old remedy. The first systematic study showing the benefits of digitalis in cases of dropsy was reported by the English physician and botanist William Withering in 1785. Subsequent widespread use of digitalis led to a greater understanding of its mechanisms of action: but until recently, the evidence on its clinical efficacy in heart failure was derived from small, often uncontrolled trials. The only adequately powered study to date to assess the impact of digoxin on survival in heart failure remains the Digitalis Investigation Group (DIG) trial.2 Multiple post-hoc analyses of the DIG trial have been undertaken to determine the efficacy of digoxin in a variety of subpopulations, the results of which continue to fuel debate over its role in the management of heart failure.