Comparing Acetazolamide and Dapagliflozin Added to IV Loop Diuretics for Adults with Acute Decompensated Heart Failure

What this Trial Is About

Researchers are comparing the effects of acetazolamide versus dapagliflozin when added to standard intravenous loop diuretics in adults with acute decompensated heart failure ADHF who show clinical signs of volume overload. This study aims to determine which drug better reduces N-terminal pro-B-type natriuretic peptide NT-proBNP levels and improves loop diuretic efficiency, helping to clear excess fluid from the body. The study is a prospective, randomized trial involving adult patients admitted with ADHF and confirmed heart failure by echocardiography. Participants are randomly assigned to receive either oral acetazolamide 500 mg once daily or oral dapagliflozin 10 mg once daily for three days, alongside intravenous loop diuretics given at double the oral maintenance dose. The loop diuretics are administered as a single bolus immediately after randomization, followed by two or more divided doses over the next two days. Treatment adherence and effects are assessed using the modified ADVOR congestion score, which evaluates edema, pleural effusion, and ascites. Throughout the study, participants will have regular assessments of heart failure symptoms, body weight, laboratory tests, and imaging to evaluate heart function. Researchers will monitor outcomes including changes in NT-proBNP levels, weight loss related to diuretic use, hospital stay duration, mortality within 30 days, and kidney function. Follow-up continues until hospital discharge and for 30 days after starting treatment, ensuring comprehensive safety and effectiveness data collection.

Acetazolamide Versus Dapagliflozin in Acute Decompensated Heart Failure Patients