Digoxin as a Treatment Option for Heart Failure with Reduced Ejection Fraction

Abstract

Digoxin is a cardiovascular drug obtained from the plant leaf of Digitalis lanata. Digoxin has a long history of usage in cardiovascular treatment. There is ongoing discussion over this drug's mode of action and therapeutic effectiveness. Positive inotropic and neurohormonal modulation effects of digoxin are found. Since the advent of beta-blockers and aldosterone antagonists as components of modern heart failure therapy, the rate of digoxin prescriptions has fallen. American and European heart failure therapy recommendations still include digoxin as a possible course of action. Since the first Digitalis Investigation Group trial findings were made public, observational studies and post hoc analyses have raised concerns about the clinical efficacy and long-term safety of digoxin. In this review, we analyze the clinical evidence, effectiveness and the safety of digoxin in patients with heart failure and lower ejection fraction.