A New Proposed Nomogram for Digoxin Dosing in HF

The popularity of digoxin in the treatment of heart failure (HF) has waxed and waned for decades. Digoxin may have modest benefits in systolic HF, but its therapeutic index is narrow and plasma concentrations exceeding 1.2 ng/mL are associated with adverse outcomes, according to recent data (Journal Watch Cardiology Jun 20 2003). Although current HF guidelines recommend concentrations of 0.5 ng/mL to 0.9 ng/mL, existing methods for estimating appropriate digoxin doses have been based on higher target concentrations.

Now, using regression analysis, researchers have created a digoxin-dosing nomogram with a goal of achieving a steady-state concentration of 0.7 mg/dL. The source data were from 54 retrospectively identified hospitalized adults wh…