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Digoxin therapy: A persisting interest despite contrary winds

Authors
Journal
Archives of Cardiovascular Diseases
1875-2136
Publisher
Elsevier
Publication Date
Volume
103
Issue
5
Identifiers
DOI: 10.1016/j.acvd.2010.04.001
Keywords
  • Digoxin
  • Heart Failure
  • Morbimortality
  • Blockers Of The Renin-Angiotensin System
  • Health Cost
  • Digoxine
  • Insuffisance Cardiaque
  • Morbi-Mortalité
  • Bloqueurs Du Système Rénine-Angiotensine
  • Coût De La Santé
Disciplines
  • Medicine
  • Pharmacology

Abstract

Abstract Digoxin therapy is used to treat heart failure patients for more than 200 years. However, absence of effect on overall mortality found in the DIG study associated with frequent adverse effects due to overdosing in elderly patients with impaired renal function finally persuaded medical opinion to the weak interest of digoxin in chronic heart failure. Its image of old-fashioned drug in the mind of young cardiology generations appears widely distorted, and suffers from the absence of promotion by pharmaceutical industry, given a very low cost and a rapid arrival onto the generic market. Yet, regarding strict data from the literature, it remains a lot of positive factors in favor of the interest for digoxin: reduction of morbidity, reduction of mortality at low serum concentration < 1.0 ng/ml, very low cost with favorable cost-effectiveness ratio. This article challenges some arguments for defending digoxin as another first-line therapy as well as ACE inhibitors and beta-blockers in the treatment of chronic heart failure.

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