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Low-dose digitoxin added to guideline-directed medical therapy (GDMT) significantly lowered hospitalization and all-cause mortality in symptomatic heart failure patients with reduced ejection fraction (HFrEF). The DIGIT-HF trial demonstrated safety and efficacy in a population with high symptom burden when serum digitoxin concentrations were carefully titrated between 8 and 18 ng/mL. This supports a reconsideration of cardiac glycosides like digitoxin as adjunctive therapy in selected HFrEF patients.
