Journal Article10.1056/NEJM199312093292417
Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting-enzyme inhibitors.
Milton Packer,Milton Packer,Mihai Gheorghiade,James B. Young,Peter J. Costantini,Kirkwood F. Adams,Robert J. Cody,L. Kent Smith,Lucy Van Voorhees,Lynn A. Gourley,M. King Jolly +10 more
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TL;DR: Patients with New York Heart Association class II or III heart failure and left ventricular ejection fractions of 35 percent or less in normal sinus rhythm who were clinically stable while receiving digoxin, diuretics, and an angiotensin-converting-enzyme inhibitor were studied.
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Abstract: Background. Although digoxin is effective in the treatment of patients with chronic heart failure who are receiving diuretic agents, it is not clear whether the drug has a role when patients are receiving angiotensin-converting-enzyme inhibitors, as is often the case in current practice. Methods. We studied 178 patients with New York Heart Association class II or III heart failure and left ventricular ejection fractions of 35 percent or less in normal sinus rhythm who were clinically stable while receiving digoxin, diuretics, and an angiotensin-converting-enzyme inhibitor (captopril or enalapril). The patients were randomly assigned in a double-blind fashion either to continue receiving digoxin (85 patients) or to be switched to placebo (93 patients) for 12 weeks
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Citations
2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
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ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult
Sharon A. Hunt,William T. Abraham,Marshall H. Chin,Arthur M. Feldman,Gary S. Francis,Theodore G. Ganiats,Mariell Jessup,Marvin A. Konstam,Donna Mancini,Keith Michl,John A. Oates,Peter S. Rahko,Marc A. Silver,Lynne W. Stevenson,Clyde W. Yancy,Elliott M. Antman,Sidney C. Smith,Cynthia D. Adams,Jeffrey L. Anderson,David P. Faxon,Valentin Fuster,Jonathan L. Halperin,Loren F. Hiratzka,Alice K. Jacobs,Rick A. Nishimura,Joseph P. Ornato,Richard L. Page,Barbara Riegel +27 more
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Cardiac Resynchronization in Chronic Heart Failure
William T. Abraham,Westby G. Fisher,Andrew L. Smith,David B. Delurgio,Angel R. Leon,Evan Loh,Dusan Z. Kocovic,Milton Packer,Alfredo L. Clavell,David L. Hayes,Myrvin H. Ellestad,Robin J. Trupp,Jackie Underwood,Faith Pickering,Cindy Truex,Peggy McAtee,John C. Messenger +16 more
TL;DR: Cardiac resynchronization results in significant clinical improvement in patients who have moderate-to-severe heart failure and an intraventricular conduction delay.
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ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure).
TL;DR: The American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines regularly reviews existing guidelines to determine when an update or full revision is needed.
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Cardiac resynchronization in chronic heart failure
W Illiam T. A Braham,W Estby G. F Isher,L. S Mith,D Avid B. D Elurgio,A Ngel R. L Eon,E Van L Oh,D Usan Z. K Ocovic,M Ilton P Acker,L. C Lavell,D Avid L. H Ayes,M Yrvin E Llestad,J Ohn M Essenger,Miracle S Tudy G Roup +12 more
- 01 Jan 2002
TL;DR: In this paper, a double-blind trial was conducted to evaluate atrialsynchronized biventricular pacing for patients with moderate-to-severe symptoms of heart failure associated with an ejection fraction of 35 percent or less and a QRS interval of 130 msec or more.
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References
Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure.
TL;DR: The addition of enalapril to conventional therapy significantly reduced mortality and hospitalizations for heart failure in patients with chronic congestive heart failure and reduced ejection fractions.
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Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. results of the survival and ventricular enlargement trial
Marc A. Pfeffer,Eugene Braunwald,Lemuel A. Moyé,Lofty L. Basta,Edward J. Brown,Thomas E. Cuddy,Barry R. Davis,Edward M. Geltman,Steven Goldman,Greg C. Flaker,Marc Klein,Gervasio A. Lamas,Milton Packer,Jacques R. Rouleau,Jean L. Rouleau,John D. Rutherford,John H. Wertheimer,C. Morton Hawkins +17 more
TL;DR: In patients with asymptomatic left ventricular dysfunction after myocardial infarction, long-term administration of captopril was associated with an improvement in survival and reduced morbidity and mortality due to major cardiovascular events.
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A Comparison of Enalapril with Hydralazine–Isosorbide Dinitrate in the Treatment of Chronic Congestive Heart Failure
Jay N. Cohn,Gary R. Johnson,Susan Ziesche,Frederick R. Cobb,Gary S. Francis,Felix E. Tristani,Raphael F. Smith,W. Bruce Dunkman,Henry S. Loeb,Maylene Wong,Geetha Bhat,Steven Goldman,Ross D. Fletcher,James J. Doherty,C. Vincent Hughes,Peter E. Carson,Guillermo Cintron,Ralph Shabetai,Clair Haakenson +18 more
TL;DR: The different effects of the two regimens (enalapril and hydralazine-isosorbide dinitrate) on mortality and physiologic end points suggest that the profile of effects might be enhanced if the regimens were used in combination.
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•Journal Article
The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure
Gordon H. Guyatt,Michael J. Sullivan,Penelope J. Thompson,Ernest L. Fallen,S. O. Pugsley,D W Taylor,Leslie B. Berman +6 more
TL;DR: It is concluded that the 6-minute walk is a useful measure of functional exercise capacity and a suitable measure of outcome for clinical trials in patients with chronic heart failure.
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Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin converting enzyme inhibitors
M. Packer,M. Gheorghiade,P. Costantini,K. Adams,R. Cody,L. K. Smith,L. Van Voorhees,L. Gourley,M. K. Jolly +8 more
- 15 Jan 2010
TL;DR: Worsening heart failure necessitating withdrawal from the study developed in 23 patients switched to placebo, but in only 4 patients who continued to receive digoxin (P<0....
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