Heart failure & cardiomyopathies
Natriuretic Response to Acetazolamide in Patients With Acute Heart Failure and Volume Overload
Authors' conclusion
Increased natriuresis is strongly related to successful decongestion with acetazolamide in ADHF.
Study context
- Population
- Patients with acute decompensated heart failure (ADHF) and volume overload in the ADVOR trial with complete urine output and urine sodium dataof 519 (89%) ADVOR patients
- Participants
- 462 patients
- Comparison
- Acetazolamide vs no acetazolamide
- Primary endpoint
- Natriuresis (UNa and total natriuresis) and its relationship with the main trial endpoints
- Follow-up
- 2 days after randomization
Primary result
As reported in the abstract
Natriuresis
Mean UNa (all patients)
92 ± 25 mmol/L
Total natriuresis (all patients)
425 ± 234 mmol
Acetazolamide independently predicted increase in UNa
16 mmol/L
19%
Acetazolamide independently predicted greater total natriuresis
115 mmol
32%
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause death or HF readmission, per 10 mmol/L UNa increaseMultivariable adjusted · after multivariable adjustments | 0.92 (0.85–0.99) | |
| 0.512Hazard ratio (log scale) |
Decongestion · first morning of assessment
- Stronger natriuretic response associated with faster, more complete relief of volume overload; significant on first morning
- P = 0.022
- Interaction between acetazolamide and UNa on decongestion
- P = 0.007
Hospital stay
- Stronger natriuresis with better decongestion translated into shorter hospital stay
- P < 0.001
Original publication
Natriuretic Response to Acetazolamide in Patients With Acute Heart Failure and Volume Overload. J Am Coll Cardiol. Published 23 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →