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May 28, 2003

Optimal Digoxin Concentrations for Patients With Heart Failure

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(20):2643. doi:10.1001/jama.289.20.2643-a

In Reply: Drs Carbonin and Zuccalà note that the Digitalis Investigation Group (DIG) trial1 only evaluated patients in sinus rhythm. As such, the relevance of our analysis to patients with atrial fibrillation is not known. We support their call for additional research in this area.

Mr de Denus and Dr Spinler suggest that observed differences in glomerular filtration rates are insufficient to explain differences in SDCs between patients with a SDC between 0.5 and 0.8 ng/mL and patients with a SDC of 1.2 ng/mL and higher.3 As we noted, recommended digoxin doses were not only based on renal function but also included patients' age, sex, weight, and other medications.