Regarding digoxin in chronic HFrEF, which statement is correct?

• A It reduces all-cause mortality
• B It reduces heart failure hospitalizations but not mortality ✓
• C It increases ejection fraction by more than 10%
• D It is first-line therapy in sinus rhythm

Explanation

The DIG trial showed digoxin reduces heart failure hospitalizations and improves symptoms without any reduction in all-cause mortality. It inhibits Na-K ATPase, increasing intracellular calcium and contractility, but the modest inotropic gain does not translate into survival benefit. It is reserved for persistently symptomatic patients already on optimal therapy, particularly those with atrial fibrillation, never as first-line treatment.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.