ESC Heart Failure 2026 (Barcelona | May 17–20, 2026):
ESC Heart Failure 2026 (Barcelona | May 17–20, 2026):
Cardiac Glycosides Making a Comeback in Heart Failure?
* New data from DECISION, DIGIT-HF, and pooled analyses presented at ESC Heart Failure 2026 suggest low-dose Digoxin / digitoxin may reduce worsening HF events despite no clear mortality benefit.
* DECISION trial:
* 1,001 HF patients with LVEF ≤ 50%
* Low-dose digoxin added to contemporary GDMT
* Low-dose oral Digoxin was dose-adjusted to maintain serum levels of 0.5–0.9 ng/mL, typically around 0.125 mg daily.
* Generally well tolerated and safe.
* Possible strongest benefit:
* Advanced HF
* NYHA III–IV
* Reduced EF
* Possibly patients with Atrial Fibrillation.
* Important clinical message:
* Routine discontinuation of digoxin in stable HF patients may worsen outcomes.
* Published simultaneously in:
* Nature Medicine
* JAMA
* European Heart Journal
during ESC HF 2026.
