Heart failure & cardiomyopathiesRandomised controlled trial
Low-dose digoxin in patients with heart failure with reduced or mildly reduced ejection fraction: a randomized controlled trial
- Randomised controlled trial
- double-blind
- placebo-controlled
Authors' conclusion
The results of this trial indicate that in patients with heart failure and reduced or mildly reduced ejection fraction, low-dose digoxin did not significantly reduce the composite endpoint of total worsening heart failure events or cardiovascular mortality.
Study context
- Population
- Symptomatic chronic HF with LVEF ≤50% (mean age 72 ± 9 years, 28% women, 29% AF)
- Participants
- 1,001 participants
- Comparison
- Low-dose digoxin vs placebo
- Digoxinn = 500
- Placebon = 501reference
- Primary endpoint
- Composite of:
- Total worsening HF events (total hospitalizations or urgent hospital visits for worsening HF)
- CV mortality
- Follow-up
- Median 36.5 months
Primary result
As reported in the abstract
Rate ratio
0.81
95% CI 0.61–1.07
P = 0.133
Events by treatment group
Digoxin
131
events
Placebo
152
events
Digoxin vs Placebo
rate ratio 0.81 (95% CI 0.61–1.07); P = 0.133
Further findings
| Outcome | Digoxin | Placebo | Estimate | |
|---|---|---|---|---|
| Total worsening HF events | 155 events | 203 events | rate ratio 0.76 (95% CI 0.54–1.05) | |
| CV mortality | 17% | 18% | HR 0.93 (95% CI 0.69–1.26) | |
| 0.512Ratio (log scale) |
Results by sex
- Results similar between men and women
Safety
Tolerability and safety
- Low-dose digoxin generally well tolerated and safe
Original publication
Low-dose digoxin in patients with heart failure with reduced or mildly reduced ejection fraction: a randomized controlled trial. Nat Med. Published 10 May 2026. doi:10.1038/s41591-026-04406-6
Summarised from the published abstract; every number is checked against it