A randomized trial published in JAMA Network evaluates whether adding digoxin to usual care reduces adverse outcomes in patients with symptomatic rheumatic heart disease (RHD). The study compares digoxin with placebo and follows patients to assess a composite endpoint that includes all-cause death and new-onset or worsening heart failure. The trial specifically targets people who already have symptoms related to rheumatic heart disease, aiming to determine whether digoxin provides clinical benefit beyond standard treatment. According to the trial’s research summary, investigators examine whether digoxin affects the risk of death or progression to heart failure when used as an adjunct therapy. The primary focus is the composite outcome of all-cause mortality and heart-failure events, reflecting both survival and worsening clinical status. The report presents the design and results of this randomized comparison, contributing evidence on the potential role of digoxin in managing symptomatic rheumatic heart disease.