Digoxin Misses Heart Failure Endpoint

Researchers observed fewer worsening heart failure events, but the trial did not establish a statistically significant benefit.

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The DECISION trial randomized 1,001 patients with symptomatic heart failure and an LVEF of 50% or less to low-dose digoxin or placebo.
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Over a median 36.5 months, digoxin did not significantly reduce the primary composite of worsening heart failure events and cardiovascular mortality.
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The primary outcome included 238 events among 500 digoxin recipients and 291 among 501 placebo recipients, at rates of 15.7 and 19.3 per 100 patient-years.
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Cardiovascular mortality was similar between groups, occurring in 83 patients (17%) receiving digoxin and 88 (18%) receiving placebo.
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Exploratory subgroup and on-treatment analyses did not establish efficacy, and the authors concluded that digoxin did not significantly reduce the primary endpoint.

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