{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T02:52:33Z","timestamp":1788058353774,"version":"build-2784847793"},"reference-count":34,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Netherlands Heart Foundation","award":["2018B024"],"award-info":[{"award-number":["2018B024"]}]},{"name":"Cardiology Fund of the UMC Groningen"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This report describes the baseline characteristics of the DECISION trial (Digoxin Evaluation in Chronic heart failure: Investigational Study In Outpatients in the Netherlands) and compares these with the other trials of cardiac glycosides in heart failure (HF): DIG and DIGIT-HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The DECISION trial is a randomized, double-blind, parallel-group, placebo-controlled outcome trial investigating of low-dose digoxin in contemporary patients with heart failure with a left ventricular ejection fraction (LVEF) \u226450%. Patients were randomized 1:1 to low-dose digoxin or placebo. During follow-up, serum digoxin concentrations were monitored to achieve concentrations of 0.5\u20130.9\u2005ng\/ml. The primary endpoint is a composite of cardiovascular mortality, total HF-hospitalizations and urgent HF hospital visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1002 patients were randomized to digoxin or placebo and 1001 patients were included in the full analysis set. Mean age was 73 \u00b1 9 years, 28% were women and 88% were in New York Heart Association class II. Mean LVEF was 33 \u00b1 9%, and 79% had a LVEF \u226440%. At baseline, 71% had sinus rhythm and 29% had atrial fibrillation. Median N-terminal pro-B-type natriuretic peptide (NT-proBNP) was 1404\u2005pg\/ml [930\u20132344].<\/jats:p>\n                    <jats:p>Patients were well-treated with guideline-directed medical therapy (GDMT): beta-blockers (87%), ACE inhibitors or ARBs or angiotensin receptor-neprilysin inhibitors (89%), mineralocorticoid receptor antagonists (72%), and sodium-glucose co-transporter 2 inhibitors (41%) and loop-diuretics (74%). Compared with other digitalis trials, DECISION-patients were older, more often women and had high prevalence of GDMT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DECISION enrolled a contemporary and well-treated population of patients with HFrEF and HFmrEF and will provide important evidence regarding the efficacy and safety of low-dose digoxin on outcome in patients with reduced or mildly reduced LVEF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag073","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T15:36:59Z","timestamp":1773329819000},"source":"Crossref","is-referenced-by-count":6,"title":["Heart failure patients with reduced or mildly reduced ejection fraction: baseline characteristics of the low-dose digoxin outcome DECISION trial"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9705-4413","authenticated-orcid":false,"given":"Peter","family":"van der Meer","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen , PO Box 30.001, Groningen 9700RB ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8403-0562","authenticated-orcid":false,"given":"Geert H D","family":"Voordes","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen , PO Box 30.001, Groningen 9700RB ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2587-8402","authenticated-orcid":false,"given":"Marlene A T","family":"Vijver","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen , PO Box 30.001, Groningen 9700RB ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6906-2643","authenticated-orcid":false,"given":"Arend","family":"Mosterd","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Meander Medical Center , Amersfoort ,","place":["The Netherlands"]},{"name":"Dutch Network for Cardiovascular Research (WCN) , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A Marco","family":"Alings","sequence":"additional","affiliation":[{"name":"Dutch Network for Cardiovascular Research (WCN) , Utrecht ,","place":["The Netherlands"]},{"name":"Department of Cardiology, Amphia Medical Center , Breda ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester L","family":"Maas-Soer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen , PO Box 30.001, Groningen 9700RB ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agaath H","family":"de Vos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen , PO Box 30.001, Groningen 9700RB ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9397-7109","authenticated-orcid":false,"given":"Astrid","family":"Schut","sequence":"additional","affiliation":[{"name":"Dutch Network for Cardiovascular Research (WCN) , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoinette D J","family":"van Asselt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University Medical Center Groningen, University of Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel L","family":"Bouvy","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University , Utrecht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan G P","family":"Tijssen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0190-2228","authenticated-orcid":false,"given":"Kevin","family":"Damman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen , PO Box 30.001, Groningen 9700RB ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"Schaap","sequence":"additional","affiliation":[{"name":"Dutch Network for Cardiovascular Research (WCN) , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernst E","family":"van der Wall","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5417-4415","authenticated-orcid":false,"given":"Adriaan A","family":"Voors","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen , PO Box 30.001, Groningen 9700RB ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry J G 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