In addition, the high dose and high SDC target used in the DIG trial may have led to a higher SDC, thus attenuating the effect of digoxin on outcomes. CI 0.57C0.75; 0.001). Digoxin-associated HRs (95% CI) for 2-year all-cause mortality or all-cause hospitalization for subgroups with NYHA IIICIV, LVEF 25%, and CTR 55% were 0.88 (0.80C0.97; = 0.012), 0.84 (0.76C0.93; = 0.001), and 0.85 (0.77C0.94; = 0.002), respectively. Conclusions Digoxin improves outcomes in chronic HF patients with NYHA class IIICIV, LVEF 25%, or CTR 55%, and should be considered in these patients. (%)= 1118)= EPLG1 1105)= 1127)= 1129)= 1175)= 1170) 0.001], 0.61 (95% CI 0.53C0.71; 0.001), and 0.65 (95% CI 0.57C0.75; 0.001), respectively (and 0.001) and at high SDC (HR 0.72; 95% CI 0.59C0.87; = 0.001; data not presented in the 4-Aminobutyric acid tables).?tables). Open in a separate window Figure 1 KaplanCMeier plots for heart failure (HF) mortality or HF hospitalization by treatment groups in high-risk patients with chronic HF in the DIG trial: (= 1118)(= 1105)?HF mortality or HF hospitalization29% (329)40% (445)C11%0.65 (0.57C0.75) 0.001?All-cause mortality or all-cause hospitalization70% (779)72% (795)C2%0.88 (0.80C0.97)0.012LVEF 25%(= 4-Aminobutyric acid 1127)(= 1129)?HF mortality or HF hospitalization27% (304)39% (444)C12%0.61 (0.53C0.71) 0.001?All-cause mortality or all-cause hospitalization64% (716)68% (767)C4%0.84 (0.76C0.93)0.001Cardiothoracic ratio 55%(= 1175)(= 1170)?HF mortality or HF hospitalization29% (336)40% (465)C11%0.65 (0.57C0.75) 0.001?All-cause mortality or all-cause hospitalization65% (764)69% (805)C4%0.85 (0.77C0.94)0.002High risk (any of the above)(= 2191)(= 2176)?HF mortality or HF hospitalization26% (566)36% (783)C10%0.66 (0.59C0.73) 0.001?All-cause mortality or all-cause hospitalization64% (1391)67% (1459)C3%0.87 (0.81C0.94) 0.001 Open in a separate window CI, confidence interval; HF, heart failure. aAbsolute risk differences were calculated by subtracting percentage events in patients receiving placebo from those in patients receiving digoxin. Two-year all-cause mortality or all-cause hospitalization Compared with the patients receiving placebo, digoxin-associated HRs for the combined endpoint of 2-year total death or all-cause hospitalization in subgroups with NYHA class IIICIV symptoms, LVEF 25%, and CTR 55% were 0.88 (95% CI 0.80C0.97; = 0.012), 0.84 (95% CI 0.76C0.93; = 0.001), and 0.85 (95% CI 0.77C0.94; = 0.002), respectively (and 0.001), but not at high SDC (HR 0.95; 95% CI 0.84C1.08; = 0.437; data not presented in the tables). Other 2-year outcomes Digoxin significantly reduced the risk of HF and all-cause hospitalization in all three subgroups of high-risk HF patients (= 0.007; = 1118)(= 1105)?All-cause mortality30% (340)30% (330)0%1.00 (0.86C1.16)0.988?CV mortality25% (276)25% (277)0%0.97 (0.82C1.14)0.686?HF 4-Aminobutyric acid mortality12% (130)13% (147)C1%0.86 (0.68C1.09)0.204?All-cause hospitalization61% (678)64% (709)C3%0.86 (0.78C0.96)0.005?CV hospitalization47% (525)53% (590)C6%0.79 (0.70C0.88) 0.001?HF hospitalization26% (290)37% (404)C11%0.63 (0.54C0.74) 0.001?All-cause mortality or HF hospitalization44% (491)51% (565)C7%0.76 (0.68C0.86) 0.001?CV mortality or HF hospitalization39% (441)48% (533)C9%0.73 (0.64C0.82) 0.001LVEF 25%(= 1127)(= 1129)?All-cause mortality29% (321)29% (329)0%0.96 (0.82C1.12)0.600?CV mortality24% (273)25% (287)C1%0.94 (0.79C1.10)0.433?HF mortality10% (116)13% (144)C3%0.79 (0.62C1.01)0.062?All-cause hospitalization54% (603)61% (683)C7%0.79 (0.71C0.88) 4-Aminobutyric acid 0.001?CV hospitalization42% (475)50% (569)C8%0.75 (0.66C0.84) 0.001?HF hospitalization24% (271)36% (406)C12%0.60 (0.51C0.70) 0.001?All-cause mortality or HF hospitalization41% (466)50% (568)C9%0.73 (0.65C0.83) 0.001?CV mortality or HF hospitalization38% (433)48% (542)C10%0.71 (0.63C0.81) 0.001Cardiothoracic ratio 55%(= 1175)(= 1170)?All-cause mortality29% (335)28% (332)+1%0.99 (0.85C1.16)0.933?CV mortality23% (274)24% (277)C1%0.97 (0.82C1.15)0.759?HF mortality9% (107)13% (148)C4%0.71 (0.56C0.91)0.007?All-cause hospitalization57% (667)62% (727)C5%0.83 (0.74C0.92) 0.001?CV hospitalization44% (521)53% (615)C9%0.76 (0.68C0.86) 0.001?HF hospitalization27% (311)36% (421)C9%0.67 (0.58C0.77) 0.001?All-cause mortality or HF hospitalization43% (506)50% (579)C7%0.79 (0.70C0.89) 0.001?CV mortality or HF hospitalization40% (465)46% (543)C6%0.77 (0.68C0.87) 0.001High risk (any of the above)(= 2191)(= 2176)?All-cause mortality26% (570)26% (567)0%0.99 (0.88C1.11)0.806?CV mortality21% (467)22% (475)C1%0.96 (0.85C1.10)0.574?HF mortality9% (192)11% (235)C2%0.80 (0.66C0.97)0.023?All-cause hospitalization55% (1204)60% (1309)C5%0.84 (0.78C0.91) 0.001?CV hospitalization43% (935)49% (1076)C6%0.79 (0.72C0.86) 0.001?HF hospitalization23% (509)33% (718)C10%0.64 (0.57C0.72) 0.001?All-cause mortality or HF hospitalization39% (859)46% (1008)C7%0.77 (0.70C0.84) 0.001?CV mortality or HF hospitalization36% (784)44% (946)C8%0.75 (0.68C0.82) 0.001 Open in a separate window CI, confidence interval;.