Heart failure & cardiomyopathies
Combining Loop and Thiazide Diuretics Across the Left Ventricular Ejection Fraction Spectrum: The CLOROTIC Trial
Authors' conclusion
Adding HCTZ to intravenous furosemide seems to be effective strategy for improving diuretic response in AHF without treatment effect modification according to baseline LVEF.
Study context
- Population
- Patients with acute HF, by left ventricular ejection fraction (LVEF) (>40% vs ≤40%)166 LVEF >40%, 64 LVEF ≤40%
- Participants
- 230 patients
- Comparison
- Hydrochlorothiazide (HCTZ) vs placebo added to IV furosemide, by LVEF
- Primary endpoint
- Influence of LVEF on primary and secondary outcomes
Methodological detailspost hoc, double-blind, placebo-controlled
- Post hoc
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
Weight loss, diuretic response and 24-hour diuresis by LVEF category
No significant differences according to LVEF category (cutoffs 40% and 50%) or LVEF as a continuous variable
all P values were insignificant
Secondary outcomes
Mortality and rehospitalizations, by LVEF group
- No significant differences with HCTZ among the 2 LVEF groups
- all P values were insignificant
Safety
Impaired renal function, hyponatremia, hypokalemia, by LVEF group
- No significant differences with HCTZ among the 2 LVEF groups
- all P values were insignificant
Original publication
Combining Loop and Thiazide Diuretics Across the Left Ventricular Ejection Fraction Spectrum: The CLOROTIC Trial. JACC Heart Fail. Published 26 June 2024. doi:10.
Summarised from the published abstract; every number is checked against it