Heart failure & cardiomyopathies
Renal function and decongestion with acetazolamide in acute decompensated heart failure: the ADVOR trial
Authors' conclusion
Acetazolamide is associated with a higher rate of successful decongestion across the entire range of renal function with more pronounced effects regarding natriuresis and diuresis in patients with a lower eGFR. While WRF occurred more frequently with acetazolamide, this was not associated with adverse clinical outcomes.
Study context
- Population
- Patients with acute decompensated HF (acute decompensated heart failure (ADHF)); median estimated glomerular filtration rate (eGFR) 40 (30–52) mL/min/1.73 m² on admission
- Participants
- 519 patients
- Comparison
- IV acetazolamide vs placebo on top of IV loop diuretics, by baseline renal function
- Primary endpoint
- Decongestion, diuresis, natriuresis and clinical outcomes according to baseline renal function; changes in renal function
Methodological detailspre-specified analysis, placebo-controlled
- Pre-specified analysis
- Placebo-controlled
Primary result
As reported in the abstract
Effect of acetazolamide across baseline eGFR (subgroups)
- Acetazolamide consistently increased likelihood of decongestion across entire eGFR spectrum
- P-interaction = .977
- Natriuresis and diuresis higher with acetazolamide, with higher treatment effect at low eGFR
- both P-interaction < .007
Further findings
- Worsening renal function (WRF) with acetazolamide not associated with higher incidence of HF hospitalizations and mortality
- P for interaction = 0.467
- Decongestion at discharge associated with fewer adverse clinical outcomes irrespective of WRF
- P for interaction = 0.805
Safety
Worsening renal function (rise in creatinine ≥ 0.3 mg/dL) · treatment period
P < 0.001
Creatinine · 3 months
- No difference in creatinine after 3 months
- P = 0.565
Original publication
Renal function and decongestion with acetazolamide in acute decompensated heart failure: the ADVOR trial. Eur Heart J. Published 25 August 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →