Many patients with heart failure and reduced EF remain at high risk for hospitalization despite evidence-based therapy. Digoxin may decrease hospitalization; however, uncertainty persists concerning its proper administration and effect on mortality. This study investigated whether using dose response concepts to re-evaluate the relationship between serum digoxin concentration and key mortality outcomes in patients with reduced EF in the Digitalis Investigation Group trial would help clarify efficacy and safety.Multivariable Cox proportional hazards modelling and propensity score adjustment assessed the relationship between serum digoxin concentration (≥0.5 ng/mL) as a continuous variable and mortality outcomes. In patients treated with digoxin, a significant linear association was found between serum concentration and all-cause mortality [adjusted hazard ratio (HR) 1.25, 95

作者：Kirkwood F, Adams；Javed, Butler；J Herbert, Patterson；Wendy, Gattis Stough；Jerry L, Bauman；Dirk J, van Veldhuisen；Todd A, Schwartz；Hani, Sabbah；John I, Mackowiak；Hector O, Ventura；Jalal K, Ghali

来源：European journal of heart failure 2016 年 18卷 8期