@article{c96ee80847cb4ddba469aa429c8bcb11,
title = "Return of digoxin and recovery of renal function",
author = "Muthiah Vaduganathan and Mihai Gheorghiade",
note = "Funding Information: Testani et al present in this issue a post hoc analysis of the Digitalis Investigation Group (DIG) trial to investigate the relationship among digoxin assignment, changes in renal function, and clinical end points. 8 This trial, funded by the National Heart, Lung, and Blood Institute and the Veterans Administration, remains the largest systematic evaluation of digoxin in patients with HF. 9 The overall DIG trial was a multicenter randomized placebo-controlled trial that evaluated digoxin added to background therapy (a regimen primarily consisting of angiotensin-converting enzyme (ACE) inhibitors and diuretics) in 6,800 patients with chronic HF and reduced ejection fraction (≤45%) in sinus rhythm, excluding patients with baseline creatinine >3.0 mg/dL. 9 Digoxin did not influence mortality, but it did significantly improve secondary end points driven by early reductions in HF hospitalizations 10 and necessity for escalation of therapy. Digoxin effect did not differ by renal function at the time of randomization. 11 Testani et al focus on the subset of patients with available 1-year serum creatinine levels. 8 The authors make 2 major conclusions: 1) Improvement in renal function (IRF), defined as ≥20% increase in estimated GFR, was more common in patients randomized to digoxin; and 2) in patients who experienced IRF, digoxin reduced composite mortality and hospitalization rates. These findings were consistently demonstrated in patients with therapeutic serum digoxin levels at 1-year follow-up. 8 ",
year = "2013",
doi = "10.1016/j.cardfail.2013.03.006",
language = "English (US)",
volume = "19",
pages = "303--305",
journal = "Journal of Cardiac Failure",
issn = "1071-9164",
publisher = "Churchill Livingstone",
number = "5",
}