WITHDRAWAL OF DIGOXIN FROM PATIENTS WITH CHRONIC HEART-FAILURE TREATED WITH ANGIOTENSIN-CONVERTING ENZYME-INHIBITORS
WITHDRAWAL OF DIGOXIN FROM PATIENTS WITH CHRONIC HEART-FAILURE TREATED WITH ANGIOTENSIN-CONVERTING ENZYME-INHIBITORS
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DOI：
10.1056/nejm199307013290101
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发表时间：
1993-07-01
影响因子：
158.5
通讯作者：
JOLLY, MK
中科院分区：
文献类型：
--
作者：
PACKER, M;GHEORGHIADE, M;JOLLY, MK
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 11 or Ill 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. Otherwise, their medical therapy for heart failure was not changed.Results. 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
