Effect of digoxin in patients with heart failure and mid-range (borderline) left ventricular ejection fraction

European Journal of Heart Failure
Azmil H Abdul-RahimVICCTA-Heart Failure Collaborators

Abstract

To evaluate the effects of digoxin in patients with the newly described phenotype of heart failure (HF) and mid-range ejection fraction (HFmrEF), attributed to mild left ventricular systolic dysfunction. We carried out a retrospective analysis of the Digitalis Investigation Group (DIG) trial which had 7788 patients available for analysis with a left ventricular ejection fraction (LVEF) ranging between 3% and 85%. We compared the effect of digoxin to placebo in three mutually exclusive groups of patients defined by LVEF category: <40% (HF with reduced LVEF, HFrEF, n = 5874), 40-49% (HFmrEF, n = 1195) and ≥50% (HF with preserved LVEF, HFpEF, n = 719). The primary outcome was the composite of cardiovascular death or HF hospitalisation. Patients with HFmrEF resembled patients with HFrEF, more than those with HFpEF, with respect to age, sex and aetiology but were more like HFpEF patients with respect to blood pressure and the prevalence of hypertension. Event rates in patients with HFmrEF were similar to those in HFpEF and much lower than in HFrEF. Digoxin reduced the primary endpoint in patients with HFrEF, mainly due to reduced HF hospitalisation: the digoxin/placebo hazard ratio (HR) for HF hospitalisation was 0.71 [95% confidenc...Continue Reading

References

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Apr 5, 2017·Circulation·Carolyn S P Lam, Scott D Solomon
Sep 28, 2017·European Journal of Heart Failure·Antoni Bayés-GenísJosep Lupón
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Oct 19, 2017·European Heart Journal·John G F ClelandUNKNOWN Beta-blockers in Heart Failure Collaborative Group

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Citations

Apr 21, 2018·European Journal of Heart Failure·Dirk J van VeldhuisenPeter van der Meer
Oct 18, 2018·European Journal of Heart Failure·Ross T CampbellJohn J V McMurray
Dec 21, 2018·ESC Heart Failure·Elisabetta DinatoloMarco Metra
Sep 3, 2019·The New England Journal of Medicine·Scott D SolomonUNKNOWN PARAGON-HF Investigators and Committees
Jan 31, 2020·ESC Heart Failure·Daniela TomasoniMarco Metra
Nov 3, 2020·Cardiac Failure Review·Davide MargonatoAndrea Mortara
Jan 13, 2021·Journal of Clinical Medicine·Eleni-Evangelia KoufouAndreas P Kalogeropoulos
Jun 1, 2021·Frontiers in Cardiovascular Medicine·Teng MaDachun Xu
Jun 12, 2021·Frontiers in Cardiovascular Medicine·Qing ZhouQingchun Zeng
Jun 8, 2021·Frontiers in Cardiovascular Medicine·Alberto Palazzuoli, Matteo Beltrami
Jun 26, 2021·Journal of the American College of Cardiology·Carolyn S P Lam, Scott D Solomon
Jun 25, 2021·Journal of Pharmacy Practice·Carrie BakerRiley D Bowers
Aug 28, 2021·European Heart Journal·Theresa A McDonaghUNKNOWN ESC Scientific Document Group
Sep 8, 2021·Nature Reviews. Cardiology·Gianluigi SavareseLars H Lund

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