Combination Oral Acetazolamide and Intravenous Furosemide on Acute Decompensated Heart Failure Outcomes

Launched by UNIVERSITAS DIPONEGORO · Jun 25, 2024

Keywords

ClinConnect Summary

This clinical trial is exploring whether taking oral acetazolamide along with intravenous furosemide can help patients with acute decompensated heart failure feel better by reducing excess fluid in their bodies. Acute decompensated heart failure is a condition where the heart cannot pump blood effectively, often leading to symptoms like swelling and shortness of breath. The researchers want to see if adding acetazolamide can improve the effectiveness of furosemide, a common diuretic or "water pill," which helps the body get rid of extra fluid. They will also measure how much urine participants produce, check changes in a specific heart-related blood marker, and assess the safety of acetazolamide.

To participate in this study, you need to be diagnosed with acute decompensated heart failure and show signs of fluid overload. You should also have been taking furosemide regularly for at least a month. The study is open to adults aged 65 and older. If you decide to join, you’ll need to sign a consent form and may undergo some tests to ensure you qualify. It’s important to note that certain conditions, like severe kidney issues or recent heart problems, may prevent you from participating. If you're interested or think you might qualify, talk to your healthcare provider for more information.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Agree to be included in the research by signing informed consent
• • Patients with a clinical diagnosis of acute decompensated heart failure with at least one clinical sign of volume overload with a congestion score ≥2 (ADVOR Score) (e.g. edema (score 2 or more), ascites confirmed by physical examination or ultrasonography or pleural effusion confirmed by chest x-ray or echocardiography).
• • Patients on routine oral loop diuretic therapy with a dose of ≥40 mg furosemide for ≥1 month
• • Plasma NT-proBNP levels that increase ≥300 pg/mL or the applicable cut-off according to the age range at the time of examination in the ER.
• Exclusion Criteria:
• • Subjects with acute coronary syndrome
• • History of congenital heart disease requiring surgical correction.
• • Subjects in cardiogenic shock.
• • Estimated glomerular filtration rate \<20 mL/min/1.73m² at the time of examination.
• • Use of renal replacement therapy or ultrafiltration at any time before the study was included.
• • Treatment with acetazolamide within 1 month before randomization.
• • Exposure to nephrotoxic agents (i.e. contrast dye) is anticipated within the next 3 days
• • Subjects who are pregnant or breastfeeding.
• • Subjects with urinary incontinence who are unwilling to use a bladder catheter.