| Digoxin | heart failure, in all type of patient | vs placebo | exacerbation of heart failure by 62% suggested hospitalisation for heart failure by 23% suggested | | Endpoint | TE [95% CI] | p val | I2 | n | k | |
|---|
| hospitalisation for cardiovascular causes | 0.92 [0.83 1.01] | p=1.00 | 0 | 6800 | 1 | Digitalis Investigation Group (DIG), | | exacerbation of heart failure | 0.38 [0.25 0.56] | p=0.04 | 0 | 1234 | 12 | Fleg, Lee, Taggart, Captopril-Digoxin Multicenter Research Group (CDMRG), German and Austrian Xamoterol Study, Guyatt, DiBianco, Pugh, Blackwood, Radiance, Proved, DIMT, | | Cardiovascular death | 0.99 [0.90 1.09] | p=1.00 | 0 | 6800 | 1 | Digitalis Investigation Group (DIG), | | hospitalisation for heart failure | 0.77 [0.69 0.85] | p=0.04 | 0 | 6978 | 2 | Radiance, Digitalis Investigation Group (DIG), | | All cause death | 0.99 [0.90 1.09] | p=1.00 | 0 | 7755 | 8 | Captopril-Digoxin Multicenter Research Group (CDMRG), German and Austrian Xamoterol Study, DiBianco, Blackwood, Radiance, Proved, DIMT, Digitalis Investigation Group (DIG), |
| Trial | Studied treatment | Control | Patients |
|---|
| Fleg, 1982 | digoxin titrated to serum level of 1.0 to 2.0 ng/mL | placebo | patients with chronic clinically compensated congestive heart failure and normal sinus rhythm | | Lee, 1982 | digoxin titrated to mean serum level of 1.15 ng/mL, mean dig dosage .435 mg/day | placebo | outpatients without atrial fibrillation | | Taggart, 1983 | digoxin (mean plasma dig level 1.2 ng/mL) | placebo (digoxin withdrawal) | patients with sinus rhythm who had a previous history of frank heart failure | | Captopril-Digoxin Multicenter Research Group (CDMRG), 1988 | digoxin of .125-.375 mg/day titrated to serum levels of .7-2.5 ng/mL | placebo (digoxin withdrawal) | patients with mild to moderate heart failure. | | German and Austrian Xamoterol Study, 1988 | digoxin .125 mg twice dayly (mean plasma dig level .87 ng/mL) | placebo | patients aged 29-80 with mild to moderate heart failure | | Guyatt, 1988 | digoxin titrated to serum level of 1.54– 2.56 nmol/L (1.2–2.0 ng/mL), mean dig dosage 0.391 mg/day | placebo | congestive heart failure patients in sinus rhythm | | DiBianco, 1989 | digoxin .125-.5 mg/ day | placebo | patients in sinus rhythm with moderately severe heart failure | | Pugh, 1989 | digoxin (patient’s “usual dose” ) | placebo (digoxin withdrawal) | patients with stable heart failure in sinus rhythm and plasma digoxin concentrations over 0.8 ng/ml | | Blackwood, 1990 | digoxin .25 mg/day | placebo | patients with heart failure | | Radiance, 1993 | digoxin titrated to serum level of 1.2 ng/mL (mean dig dosage .38 mg/day) | placebo (digoxin withdrawal) | patients with New York Heart Association class II or III heart failure and left ventricular ejection fractions of 35 percent or less in normal sinus rhythm who were clinically stable while receiving digoxin, diuretics, and an angiotensin-converting-enzyme inhibitor (captopril or enalapril) | | Proved, 1993 | digoxin titrated to serum level of 1.2 ng/mL (median dig dosage .375 mg/day) | placebo (digoxin withdrawal) | patients with chronic, stable mild to moderate heart failure | | DIMT, 1993 | digoxin .25 mg/day (mean plasma level .94 ng/mL) | placebo | patients with mild to moderate chronic heart failure | | Digitalis Investigation Group (DIG), 1997 | digoxin dosage at investigators’ discretion (median baseline dosage in main trial of .25 mg/day) | placebo | patients with left ventricular ejection fractions of 0.45 or less and normal sinus rhythm |
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