Author(s):
Question:
Setting:
Bibliography:
Certainty assessment№ of patientsEffectCertaintyImportance
№ of studiesStudy designRisk of biasInconsistencyIndirectnessImprecisionOther considerationsdigoksiinimitteRelative
(95% CI)		Absolute
(95% CI)
Üldine suremus (jälgimisperiood valdavalt 3-5 aastat)
81,2,3,4,5,6,7,8,9,a
randomised trials
not serious
not serious
seriousb
not serious
none
1197/3872 (30.9%)
1211/3883 (31.2%)
OR 0.98
(0.89 to 1.09)
4 fewer per 1,000
(from 24 fewer to 19 more)
⨁⨁⨁◯
Moderate
Hospitaliseerimine südamepuudulikkuse dekompensatsiooni tõttu (jälgimisperiood valdavalt 3-5 aastat)c
41,2,5,7,a
randomised trials
not serious
not serious
seriousb
not serious
none
918/3620 (25.4%)
1206/3642 (33.1%)
OR 0.68
(0.61 to 0.75)
79 fewer per 1,000
(from 99 fewer to 60 fewer)
⨁⨁⨁◯
Moderate
Kliinilise seisundi halvenemine (jälgimisperiood 7 nädalat kuni 6 kuud)
12a,d
randomised trials
not serious
not serious
seriousb
not serious
none
39/614 (6.4%)
111/620 (17.9%)
OR 0.31
(0.21 to 0.43)
116 fewer per 1,000
(from 135 fewer to 93 fewer)
⨁⨁⨁◯
Moderate
Korduv hospitaliseerimine ühe kuu jooksule
110
observational studies
not serious
not serious
not serious
not serious
none
15/167 (9.0%)
27/167 (16.2%)
HR 0.51
(0.31 to 0.83)
76 fewer per 1,000
(from 108 fewer to 26 fewer)
⨁⨁◯◯
Low
Korduv hospitaliseerimine (jälgimisperiood 4 aastat)e
110
observational studies
not serious
not serious
not serious
not serious
none
76/167 (45.5%)
86/167 (51.5%)
HR 0.72
(0.57 to 0.92)
109 fewer per 1,000
(from 177 fewer to 29 fewer)
⨁⨁◯◯
Low

CI: confidence interval; HR: hazard Ratio; OR: odds ratio

Explanations

a. Hood, Jr. WB, Dans AL, Guyatt GH, Jaeschke R, McMurray JJV. Digitalis for treatment of heart failure in patients in sinus rhythm. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD002901.
b. Puudub info selle kohta, kas patsiendid said esmavaliku ravimeid maskimaalses talutavas annuses
c. Patsiendid: NYHA klass II-III, EF 25-29%, enamusel isheemilise geneesiga SP. Muud ravimid: DIG captopril 87% diureetikumravil; DIG study 82% diureetikumravil, 94% AKEI; PROVED 100% diureetikuravil; RADIANCE 100% ravi diureetikumi või AKEI-ga.
d. Blackwood 1990, Dig captopril 1988, Dig milrinone 1989, Dig xamoterol 1988, DIMT 1993, Fleg 1982, Guyatt 1988, Lee 1982, PROVED 1993, Pugh 1989, RADIANCE 1993, Taggart 1983
e. Kõik jälgimisuuringu patsiendid said beetablokaatorit.

References

1.Packer M, Gheorghiade M Young JB Costantini PJ Adams KF Cody RJ et al. RADIANCE. Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting-enzyme inhibitors. RADIANCE study. New England Journal of Medicine; 1993.
2.Uretsky BF, Young JB Shahidi FE Yellen LG Harrison MC Jolly MK. PROVED. Randomized study assessing the effect of digoxin withdrawal in patients with mild to moderate chronic congestive heart failure: results of the PROVED trial. PROVED Investigative Group. Journal of the American College of Cardiology; 1993.
3.van Veldhuisen DJ, Man in 't Veld AJ Dunselman PHJM Lok DJA Dohmen HJM Poortermans JC et al. DIMT. Double-blind placebo- controlled study of ibopamine and digoxin in patients with mild to moderate heart failure: results of the Dutch Ibopamine Multicenter Trial (DIMT). Journal of the American College of Cardiology; 1993.
4.TheGermanandAustrianXamoterolStudyGroup, . DIG xameterol. Double-blind placebo-controlled comparison of digoxin and xamoterol in chronic heart failure. Lancet; 1988.
5.TheDigitalisInvestigationGroup, . DIG study. Rationale, design, implementation, and baseline characteristics of patients in the DIG trial: a large, simple, long-term trial to evaluate the effect of digitalis on mortality in heart failure. Controlled Clinical Trials; 1996.
6.DiBianco R, Shabetai R,Kostuk W,Moran J,Schlant RC,Wright R. DIG milrinone. A comparison of oral milrinone, digoxin, and their combination in the treatment of patients with chronic heart failure. New England Journal of Medicine; 1989.
7.TheCaptopril-DigoxinMulticenterResearchGroup, . DIG captopril. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA; 1988.
8.Blackwood R, Mayou RA,Garnham JC,Armstrong C,Bryant B. Exercise capacity and quality of life in the treatment of heart failure.. Clinical Pharmacology & Therapeutics; 1990.
9.Hood, Jr. WB,Dans AL,Guyatt GH,Jaeschke R,McMurray JJV. Digitalis for treatment of heart failure in patients in sinus rhythm. Cochrane Database of Systematic Reviews; 2014.
10.Lam PH, Bhyan P,Arundel C,Dooley DJ,Sheriff HM,Mohammed SF,Fonarow GC,Morgan CJ,Aronow WS,Allman RM,Waagstein F,Ahmed A. Digoxin use and lower risk of 30-day all-cause readmission in older patients with heart failure and reduced ejection fraction receiving β-blockers. Clin Cardiol; 2018.