Digitalis as an Antianginal Agent

¹ Cardiology Section, Medical Service, and Radiology Service, Long Beach Veterans Administration Hospital, and the University of California College of Medicine at Irvine
² Chief of Cardiology, Long Beach Veterans Administration Hospital; Adjunct Associate Professor of Medicine, University of California College of Medicine at Irvine
³ Staff Radiologist and Chief, Angiography Section, Long Beach Veterans Administration Hospital; Associate Professor of Radiology (in Residence), University of California College of Medicine at Irvine

The effect of a 0.25 mg daily digoxin dose was evaluated in a double-blind crossover study in 17 anginal patients with a normal sized heart, 9 of whom had nocturnal angina. The frequency of anginal episodes was decreased at least 50 percent in 2 of 17 patients (12 percent) and increased at least 100 percent in 2 of 17 patients (12 percent) on digoxin compared to placebo. The frequency of nocturnal angina decreased at least 50 percent in four of nine patients (44 percent) and increased at least 100 percent in three of nine patients (33 percent) on digoxin compared to placebo. Exercise performance until angina was significantly decreased in one of eight patients (12 percent) without nocturnal angina and significantly improved in three of nine patients (33 percent) with nocturnal angina on digoxin compared to placebo. These results indicate that digitalis is of no benefit in anginal patients with a normal sized heart without nocturnal angina but should be given a therapeutic trial in patients with nocturnal angina.