Digoxin in chronic heart failure: possibility of a second chance?
| Autor: | A. Vaz Pérez, R.G. Turan, Mathias Rauchhaus |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Digoxin Cardiotonic Agents law.invention Randomized controlled trial Meta-Analysis as Topic law Internal medicine medicine Humans Sinus rhythm cardiovascular diseases Cardiac glycoside Randomized Controlled Trials as Topic Heart Failure Ejection fraction business.industry Incidence (epidemiology) General Medicine medicine.disease Natural history Treatment Outcome Heart failure Cardiology business circulatory and respiratory physiology medicine.drug |
| Zdroj: | QJM : monthly journal of the Association of Physicians. 104(4) |
| ISSN: | 1460-2393 |
| Popis: | The cardiac glycoside digoxin is one of the oldest and probably the least expensive drug for the treatment of chronic heart failure (CHF). But still treatment with this drug in patients with CHF and sinus rhythm remains highly controversial. Despite the fact that the use of digoxin in CHF is considered to be effective and safe, its use has significantly declined due to the belief that digoxin is not able to favourably affect the natural history of CHF.1 Another important fact is the occurrence of its well-known toxic side effects, although the incidence of digoxin toxicity seems to have diminished in the first years of the 21st century.2 The European Society of Cardiology guidelines for the diagnosis and treatment of acute and CHF recommend the administration of digoxin in symptomatic patients with impaired left ventricular ejection fraction (LVEF) and sinus rhythm despite its lack of effect on survival.3 This recommendation is based on level B of evidence in view of the fact that only one meta-analysis of a single randomized controlled trial, the Digoxin Investigation Group (DIG) trial, could demonstrate a reduction in CHF-associated hospital admissions.3 The DIG trial is the most relevant study investigating the long-term effects of a median … |
| Databáze: | OpenAIRE |
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