Efficacy of Oral Acetazolamide in Decongestion in Patients With Heart Failure
Heart Failure
About this trial
This is an interventional treatment trial for Heart Failure focused on measuring : Acetazolamide, Heart failure, Electrolyte Disturbance, Diuretics, Chloride, Diuretic resistance, Decongestion
Eligibility Criteria
Inclusion criteria Earn at least 8 points from EVEREST score (see Table 1.) Adult patients (≥ 18 years) A major clinical sign of volume overload including edema, ascites confirmed by abdominal ultrasound, or pleural effusion confirmed by chest x-ray or chest ultrasound without using iv furosemide. Maintenance treatment with oral furosemide as a loop diuretic ≥20 mg for at least one month Using SGLT2i drugs including canagliflozin, dapagliflozin, and empagliflozin for at least one month Exclusion criteria Systolic blood pressure less than 90 mmHg or mean arterial pressure less than 65 mmHg Estimated glomerular filtration rate (eGFR) <20 ml/min/1.73 m2 Using any diuretic agent except mineralocorticoid receptor antagonists including spironolactone and eplerenone Simultaneous diagnosis of acute coronary syndrome, which is characterized by typical chest pain in addition to an increase in troponin level above the 99th percentile or electrocardiographic changes indicating ischemia or hospitalization as unstable angina.
Sites / Locations
- Houshang bavandpour karvane
Arms of the Study
Arm 1
Arm 2
Active Comparator
Placebo Comparator
acetazolamid
placebo
We will administer injectable and oral furosemide in infusion ward based on the dosage determined by the specialist on day zero. After that, we continue oral furosemide administration for three days. The prescribed dose of injectable and oral furosemide is determined by the specialist based on previous visits and hospitalizations in such a way that the patient has the least symptoms. The intervention group will receive acetazolamide 500 mg on day zero, then 250 mg bd for two days and 250 mg on the third day. The control group will receive placebo equivalent to acetazolamide.
Acetazolamide placebo add-on a standard therapy of iv furosemide in one day and oral furosemide during three consecutive days will be used for the comparator arm.