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Family Practice Vol. 21, No. 4, 469-472
Family Practice Vol. 21, No. 4 © Oxford University Press 2004, all rights reserved.

Selections from Current Literature

Digoxin in chronic heart failure

William E Cayley, Jr

Augusta Family Medicine Clinic, Eau Claire Family Medicine Residency, University of Wisconsin Department of Family Medicine, 807 South Farwell, Eau Claire, WI 54701, USA

E-mail: bcayley@yahoo.com

Cayley WE Jr. Digoxin in chronic heart failure. Family Practice 2004; 21: 469–472.

The first 150 words of the full text of this article appear below.


   Introduction
 
Digitalis purpurea (foxglove) has been used for centuries. It was among the herbal remedies used in ancient Rome, and in the 16th century it was used in Ireland, Germany and England for ‘dropsy’ and other medical conditions. In 1785, William Withering reported on his study of digitalis extract used in 163 hospitalized patients, concluding that its beneficial action was due to effects on the power and motion of the heart. Pure digitoxin was first isolated from foxglove in 1875, and digoxin, the glycoside used today, was first isolated in 1957.1 Evidence to guide optimal management of heart failure continues to evolve, however, and the role of digitalis in heart failure has been called "the oldest continuing controversy in the history of medicine."2 The articles in this selection provide food for thought on the place of digoxin in modern evidence-based management of heart failure.


   Hunt SA, Baker DW, Chin MH et al. ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult—Executive Summary. J Am Coll Cardiol 2001; 38: 2101–2113.
 
This summary of the most recent guidelines . . . [Full Text of this Article]

Comment

   The Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med 1997; 336: 525–533.
 
Comment

   Hood WB Jr, Dans AL, Guyatt GH, Jaeschke R, McMurray JJV. Digitalis for treatment of congestive heart failure in patients in sinus rhythm. Cochrane Database of Systematic Reviews 1, 2003.
 
Comment

   Adams KF, Gheorghiade M, Uretsky BF et al. Clinical benefits of low serum digoxin concentrations in heart failure. J Am Coll Cardiol 2002; 39: 946–953.
 
Comment

   Lader E, Egan D, Hunsberger S et al. The effect of digoxin on the quality of life in patients with heart failure. J Cardiac Failure 2003; 9: 4–12.
 
Comment

   Rathore SS, Curtis JP, Wang Y et al. Association of serum digoxin concentration and outcomes in patients with heart failure. J Am Med Assoc 2003; 289: 871–878.
 
Comment

   Rea TD, Siscovick DS, Psaty BM et al. Digoxin therapy and the risk of primary cardiac arrest in patients with congestive heart failure: effect of mild–moderate renal impairment. J Clin Epidemiol 2003; 56: 646–650.
 
Comment

   Summary
 

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