Digitoxin for Heart Failure with Reduced Ejection Fraction?

Surprisingly, the cardiac glycoside, in addition to contemporary evidence-based therapy, was beneficial in patients with HFrEF.

Practice guideline support for using the cardiac glycoside digoxin in patients with heart failure (HF) has been weak since the DIG trial found that those who received digoxin did not have a lower mortality risk than those who received placebo. Now, the DIGIT-HF trial has examined the effects of another cardiac glycoside — digitoxin — that has more enteral absorption and protein binding than digoxin and is partially hepatically eliminated; this results in less variability in drug levels and presumably lower risks of toxicity.

More than 1200 European patients with HF with a reduced ejection fraction (mean left ventricular ejection fraction, 29%), most of whom were receiving evidence-based drug and device therapies for HF, were randomized to ei…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, MACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)