RANDOMIZED STUDY ASSESSING THE EFFECT OF DIGOXIN WITHDRAWAL IN PATIENTS WITH MILD-TO-MODERATE CHRONIC CONGESTIVE-HEART-FAILURE - RESULTS OF THE PROVED TRIAL

被引：429

作者：

URETSKY, BF ^{[1
]}

YOUNG, JB ^{[1
]}

SHAHIDI, FE ^{[1
]}

YELLEN, LG ^{[1
]}

HARRISON, MC ^{[1
]}

JOLLY, MK ^{[1
]}

AWAN, N ^{[1
]}

SEARS, C ^{[1
]}

SEARS, L ^{[1
]}

BAJWA, T ^{[1
]}

MAGLIO, C ^{[1
]}

CARLSON, C ^{[1
]}

COLFER, HT ^{[1
]}

GRAHAM, K ^{[1
]}

SHAW, C ^{[1
]}

COSTANTINI, PJ ^{[1
]}

STANLEY, D ^{[1
]}

MATHESEN, R ^{[1
]}

DAUER, A ^{[1
]}

HOLT, V ^{[1
]}

DETJE, R ^{[1
]}

CHISOLM, C ^{[1
]}

FILIP, JR ^{[1
]}

PERRI, S ^{[1
]}

FISHER, M ^{[1
]}

GREENBERG, N ^{[1
]}

KRITCHEN, C ^{[1
]}

GALYEAN, J ^{[1
]}

SMITH, SJ ^{[1
]}

GOLDSCHER, D ^{[1
]}

DEPETRIS, S ^{[1
]}

GOODMAN, L ^{[1
]}

LANIER, S ^{[1
]}

HILLIARD, G ^{[1
]}

LUCERO, M ^{[1
]}

KARLSBERG, R ^{[1
]}

MACCIONI, S ^{[1
]}

PENNOCK, P ^{[1
]}

GALE, N ^{[1
]}

REYNOLDS, M ^{[1
]}

SCREWS, B ^{[1
]}

KING, K ^{[1
]}

RHODES, A ^{[1
]}

VANSELOW, B ^{[1
]}

SANDBERG, J ^{[1
]}

YURICK, C ^{[1
]}

SHAHIDI, FE ^{[1
]}

SHAHIDI, J ^{[1
]}

SOMBERG, J ^{[1
]}

机构：

[1] BURROUGHS WELLCOME CO,RES TRIANGLE PK,NC 27709

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 1993年 / 22卷 / 04期

关键词：

D O I：

10.1016/0735-1097(93)90403-N

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives. The purpose of this study was to determine whether digoxin is effective in patients with chronic, stable mild to moderate heart failure. Background. Digoxin has been a traditional therapy in heart failure, but methodologic limitations in earlier studies have prevented definitive conclusions regarding its efficacy. Methods. Withdrawal of digoxin (placebo group, n = 46) or its continuation (digoxin group, n = 42) was performed in a prospective, randomized, double-blind, placebo-controlled multicenter trial of patients with chronic, stable mild to moderate heart failure secondary to left ventricular systolic dysfunction who had normal sinus rhythm and were receiving long-term treatment with diuretic drugs and digoxin. Results. Patients withdrawn from digoxin therapy showed worsened maximal exercise capacity (median change in exercise time -96 s) compared with that of patients who continued to receive digoxin (change in exercise time +4.5 s) (p = 0.003). Patients withdrawn from digoxin therapy showed an increased incidence of treatment failures (p = 0.039) (39%, digoxin withdrawal group vs. 19%, digoxin maintenance group) and a decreased time to treatment failure (p = 0.037). In addition, patients who continued to receive digoxin had a lower body weight (p = 0.044) and heart rate (p = 0.003) and a higher left ventricular ejection fraction (p = 0.016). Conclusions. These data provide strong evidence of the clinical efficacy of digoxin in patients with normal sinus rhythm and mild to moderate chronic heart failure secondary to systolic dysfunction who are treated with diuretics.

引用

页码：955 / 962

页数：8

共 18 条

[1]

BERRY DA, 1990, STATISTICAL METHODOL, P389

[2]

BORG GA, 1973, MED SCI SPORTS EXERC, V50, P90

[3]

CHRISTIAN HA, 1922, MED CLIN N AM, V5, P1173

[4]

DEBIANCO R, 1989, NEW ENGL J MED, V320, P677

[5]

DIENBERG SC, 1977, ANAL CROSS CLASSIFIC, P9

[6]

GERMAN, 1988, LANCET, V1, P488

[7]

GUYATT GH, 1985, CAN MED ASSOC J, V132, P919

[8] A CONTROLLED TRIAL OF DIGOXIN IN CONGESTIVE HEART-FAILURE [J].

GUYATT, GH ;

SULLIVAN, MJJ ;

FALLEN, EL ;

TIHAL, H ;

RIDEOUT, E ;

HALCROW, S ;

NOGRADI, S ;

TOWNSEND, M ;

TAYLOR, DW .

AMERICAN JOURNAL OF CARDIOLOGY, 1988, 61 (04) :371-375

[9] HEART-FAILURE IN OUTPATIENTS - A RANDOMIZED TRIAL OF DIGOXIN VERSUS PLACEBO [J].

LEE, DCS ;

JOHNSON, RA ;

BINGHAM, JB ;

LEAHY, M ;

DINSMORE, RE ;

GOROLL, AH ;

NEWELL, JB ;

STRAUSS, HW ;

HABER, E .

NEW ENGLAND JOURNAL OF MEDICINE, 1982, 306 (12) :699-705

[10]

LEE ET, 1980, STATISTICAL METHODS, P129

← 1 2 →