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Evidence summaries

Digitalis for Congestive Heart Failure in Patients in Sinus Rhythm

Digitalis reduces the rate of hospitalisation and clinical deterioration with a neutral effect on mortality. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 13 studies with a total of 7 896 subjects. Treatment with digoxin had no effect on death rates (OR 0.98, 95% CI 0.89 to 1.09, 8 studies, n=7 755), but this observation is based almost entirely upon one large study with 6 800 participants. There was a trend toward a lower death rate due to worsening heart failure (p=0.06) and a significant increase in deaths due to other cardiac causes (p=0.04), possibly due to arrhythmias so, that the overall effect on mortality was neutral. Digitalis therapy was associated with a lower rate of hospitalisation (OR 0.68, 95% CI 0.61 to 0.75; relative risk reduction (RRR) 23.4%, NNT ranging from 13 to 17; 4 studies, n=7 262) and a lower rate of clinical deterioration (OR 0.31, 95% CI 0.21 to 0.43; 12 studies, n=1 234).

References

  • Hood WB Jr, Dans AL, Guyatt GH et al. Digitalis for treatment of heart failure in patients in sinus rhythm. Cochrane Database Syst Rev 2014;(4):CD002901. [PubMed]

Primary/Secondary Keywords