Digoxin Use in Modern Medicine

Shan Chen, PharmD Candidate; Troy Khusial, PharmD Candidate; Dipen Patel, PharmD Candidate; Satinder Singh, PharmD Candidate; Tatyana Yakubova, PharmD Candidate; Amy Wang, PharmD, BCPS, MBA; Timothy Nguyen, PharmD, BCPS, CCP, FASCP


US Pharmacist. 2015;40(2):44-48. 

In This Article

Morbidity and Mortality in HF

Digoxin has been shown effective for decreasing HF symptoms, and its effect on morbidity and mortality has been assessed as well. A randomized, double-blind, placebo-controlled trial was conducted to examine mortality and morbidity in HF patients with a left ventricular EF of ≤0.45 who were receiving digoxin therapy.[9] There were no baseline between-group differences, and follow-up was a mean of 37 months. The primary outcome was mortality; secondary outcomes were a composite of mortality from cardiovascular causes, death from worsening HF, and hospitalization for other causes (digoxin toxicity). In the intent-to-treat analysis, there were 1,181 deaths in the digoxin group and 1,194 deaths in the placebo group (34.8% vs. 35.1%, 95% CI 0.91–1.07, P = 0.8 [nonsignificant]). Fewer digoxin patients than placebo patients were hospitalized (910 and 1,180, respectively; risk ratio 0.72, 95% CI 0.66- 0.79, P <.001). Also, the risk associated with the combined outcome of death due to worsening HF or hospitalization was lower in the digoxin group (1,041 vs. 1,291, P <.001). The conclusion was that although digoxin had no effect on overall mortality, it significantly decreased the overall number of hospitalizations attributed to worsening HF.[9]