Digoxin: the good and the bad

Oliver Ziff, Dipak Kotecha

Research output: Contribution to journalArticlepeer-review

57 Citations (Scopus)
1832 Downloads (Pure)

Abstract

After 230 years of use, digitalis remains an important and useful therapy for patients with atrial fibrillation, heart failure, and the 30–50 % of patients with both conditions. Although the combination of positive inotropic activity with negative chronotropic effects has been shown to reduce hospital admissions in heart failure, there is a distinct lack of robust trial data, particularly in patients with atrial fibrillation. We recently performed a comprehensive meta-analysis of all digoxin studies and demonstrated a neutral effect on mortality. This contradicts prior observational data that overlook the fact that digitalis is usually given as second-line therapy to the sickest patients. Use of these agents in clinical practice should take account of appropriate dose, serum concentration, drug interactions, and potential side effects. The aim of this review is to evaluate the evidence base for cardiac glycosides and provide a pragmatic guide to their advantages and disadvantages.
Original languageEnglish
Pages (from-to)585-595
JournalTrends in Cardiovascular Medicine
Volume26
Issue number7
Early online date31 Mar 2016
DOIs
Publication statusE-pub ahead of print - 31 Mar 2016

Keywords

  • Digoxin
  • Cardiac glycoside
  • Heart failure
  • Atrial fibrillation
  • Mortality
  • Hospitalization
  • Outcomes

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