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Digoxin Does Not Lower Mortality in Diastolic HF

August, 2006 - Doctors believe that roughly half of all
CHFers have diastolic heart failure (DHF). DHF is heart
failure with normal or near-normal EF. Except for
candesartan (Atacand), no HF drugs have been tested in
trials just for DHF patients.
	There were a lot of DHF patients in the DIG
(Digitalis Investigation Group) trial, so researchers
analyzed records of those patients in this study.
	998 CHFers in normal heart rhythm with EF
higher than 45% (average EF was 53%) were included in
the trial, which was done from 1991 to 1993.
	492 took digoxin and 496 took placebo.
During an average follow-up of 37 months, 102 digoxin
patients (21%) and 119 placebo patients (24%) either
suffered heart-related death or HF hospitalization.
	Digoxin had no effect on all-cause risk of
death, heart-related risk of death, all-cause hospitalization
or heart-related hospitalization.
	There was a trend toward fewer heart-related
hospitalizations with digoxin use. However, there was
also a trend toward more hospital visits for unstable
angina.
	Researchers conclude that in mild to moderate
diastolic heart failure patients with normal heart rhythm
already on ACE inhibitors and diuretics, digoxin had little
effect.

Title:       Effects of Digoxin on Morbidity and Mortality in
               Diastolic Heart Failure - The Ancillary Digitalis
               Investigation Group Trial.
Authors: Ali Ahmed, Michael Rich, Jerome Fleg, Michael
              Zile, James Young, Dalane Kitzman, Thomas
              Love, Wilbert Aronow, Kirkwood Adams Jr,
              Mihai Gheorghiade.
Source:  Circulation. 2006;114:397-403.