Which of the following medications is not associated with a survival benefit in systolic heart failure patients.. Digoxin

Which of the following medications is not associated with a survival benefit in systolic heart failure patients?

a- ACE inhibitor

b- Digoxin

c- Beta blockers

d- Aldosterone antagonists

e- Isosorbide dinitrate/hydralazine

f- All of the above improve survival

Answer b:
ACE inhibitors and beta blockers are the mainstay treatment of heart failure with reduced EF (HF↓EF) since they improve morbidity and mortality.
Aldosterone antagonists improve survival in those with HF↓EF with NYHA functional class III/IV symptoms.
Isosorbide dinitrate/hydralazine improves outcomes in HF↓EF, but traditionally has been thought to be inferior to ACE inhibitor.
However, recent data suggest the effect of these agents may be more potent in African-Americans.
While digoxin improves hospitalize.
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