Heart failure & cardiomyopathiesRandomised controlled trial
Short-Term Effects of Pecavaptan on Weight and Congestion in Acute Heart Failure
- double-blind, randomized, placebo-controlled trial
- post hoc analysis
Authors' conclusion
In patients hospitalized for acute HF with residual congestion, pecavaptan showed modest signals of early decongestion, without durable benefit at 30 days. These post hoc findings require prospective confirmation. (A Trial to Study BAY1753011 in Patients With Congestive Heart Failure [AVANTI]; NCT03901729).
Study context
- Population
- Patients hospitalized with heart failure (HF) and incomplete decongestion
- Participants
- 482 patients
- Comparison
- Pecavaptan vs placebo
- pecavaptann = 242
- placebon = 240
Primary result
Weight change · day 7
Difference
−0.47 kg
95% CI −0.94 to −0.01
P = 0.044
By group
pecavaptan
−1.43
kg
placebo
−0.95
kg
pecavaptan vs placebo
difference −0.47 kg (95% CI −0.94 to −0.01); P = 0.044
As reported in the abstract
Further findings
| Outcome | adjusted OR (95% CI) | P value | |
|---|---|---|---|
| Resolution of pedal edema · day 7 · better resolution with pecavaptan | 0.63 (0.42–0.95) | nominal P = 0.026 | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | difference (95% CI) | P value | |
|---|---|---|---|
| Thoracic fluid content · day 7 · reduced with pecavaptan | −1.43% (−2.57 to −0.28) | nominal P = 0.015 | |
| −4−202Difference (linear scale) |
- Thoracic fluid content: Effects limited and no longer significant by day 30
Composite congestion score (CCS) · day 7
- CCS not significantly modified by pecavaptan
- P = 0.171
Plasma osmolality and serum sodium concentration · day 7 and day 30
- Increase with pecavaptan
- both P < 0.01
Baseline characteristics
- Median age, years (IQR: 62.0-78.0)
- 70
- Women
- 24% (118/482)
Original publication
Short-Term Effects of Pecavaptan on Weight and Congestion in Acute Heart Failure. JACC Adv. doi:10.1016/j.jacadv.2026.102891
Summarised from the published abstract; every number is checked against it