{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:25:00Z","timestamp":1790105100146,"version":"4.0.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,7,7]],"date-time":"2015-07-07T00:00:00Z","timestamp":1436227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovascular Therapeutics"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Digoxin is the oldest known treatment for heart failure (<jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>) and has been demonstrated to reduce admissions for worsening heart failure in a large randomized trial recruiting patients in sinus rhythm with heart failure and ejection fraction &lt;45%. This study forms the basis for current international guidelines recommending that digoxin should be considered in patients with symptomatic <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> despite optimal doses of angiotensin\u2010converting enzyme inhibitors\/angiotensin receptor blockers, <jats:italic>\u03b2<\/jats:italic>\u2010blockers, and mineralocorticoid receptor antagonists in addition to device therapy, if indicated. However, digoxin predates mortality reducing <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> therapies, and this article reviews the historical and recent data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multiple PubMed searches were performed including, but not limited to, the search terms \u201cdigoxin,\u201d \u201cheart failure,\u201d \u201cefficacy,\u201d \u201ctreatment,\u201d \u201cside\u2010effects,\u201d \u201cmorbidity,\u201d \u201cmortality,\u201d and \u201carrythmia.\u201d Articles were excluded if not relevant, not in English or without abstract. Reference lists of relevant articles were manually searched for further references. Due to the large number of articles retrieved, a selection was reviewed based on the authors\u2019 best judgement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three randomized controlled trials and three large contemporary observational reports of digoxin therapy in heart failure and sinus rhythm were retrieved. Other studies were noted that included patients with heart failure and atrial fibrillation, which were also reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Definitive randomized evidence of digoxin efficacy as add\u2010on therapy in <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> is lacking because most landmark trials of modern <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> disease modifying agents postdate the randomized studies of digoxin. Furthermore, questions remain regarding the optimum dose of digoxin and there are signals that digoxin may be harmful in some patients with <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>. All contemporary data for digoxin in <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> are derived from observational studies and the findings are conflicting. Despite two centuries of experience using cardiac glycosides to treat <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>, fundamental questions regarding the efficacy and safety of digoxin in <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> remain unanswered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1755-5922.12130","type":"journal-article","created":{"date-parts":[[2015,4,29]],"date-time":"2015-04-29T14:46:06Z","timestamp":1430318766000},"page":"236-241","source":"Crossref","is-referenced-by-count":8,"title":["Is Foxglove Effective in Heart Failure?"],"prefix":"10.1111","volume":"33","author":[{"given":"Parminder S","family":"Chaggar","sequence":"first","affiliation":[{"name":"North West Heart Centre University Hospital of South Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M","family":"Shaw","sequence":"additional","affiliation":[{"name":"North West Heart Centre University Hospital of South 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