Over 200 years after it was discovered as a therapy for heart failure, the value of digoxin (digitalis, an extract of the foxglove plant) has at last been appreciated, according to results presented at the XVIIIth Congress of the European Society of Cardiology, held in Birmingham, UK on August 26. These results showed that patients with heart failure who are administered digitalis show a clinical benefit with no change in all-cause mortality.
William Withering, the 18th century physician who discovered the potential of digitalis, demonstrated that it had an important diuretic property and subsequently wrote a book listing all the drug's adverse effects and guidelines for optimal dose achievement. This was, by and large, ignored by physicians, who tended to prescribe the drug for any common ailment, whereupon digoxin fell into disrepute.
The drug became rehabilitated in the early part of this century, but there was some disagreement between American and British doctors as to its role in heart failure when no atrial fibrillation was noted. In recent years, however, new evidence has been accumulated in several large clinical trials on the positive effects of digitalis.
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