Using acetazolamide to treat acute decompensated heart failure
|
Reviewed Dat Tien Nguyen, B.A, ScM.
|
Posted on October 14th, 2022
|
Acetazolamide is a carbonic anhydrase inhibitor that can act on the proximal tubule to induce sodium reabsorption. Thus, the agent can increase diuretic efficiency and reduce fluid accumulation. An article recently published in the New England Journal of Medicine had reported on the efficacy of acetazolamide in patients with acute decompensated heart failure with volume overload.
The trial included 519 patients that had been diagnosed with acute decompensated heart failure and have been using either 40 mg of furosemide, 1 mg of bumetanide, or 20 mg of torasemide. These patients expressed at least one clinical sign of volume overload - edema, pleural effusion, or ascites - and had a N-terminal pro–B-type natriuretic peptide (NT-proBNP) level > 1000 pg/mL or a B-type natriuretic peptide level > 250 pg/mL. Patients in the intervention group were given daily intravenous bolus of acetazolamide, 500 mg. Those in the intervention group were appropriately matched with those in the control group that were using placebo. The study found that patients who received intravenous acetazolamide are 46% more likely to achieve successful decongestion than those who received placebo. In addition, those in the intervention group experience a faster drop in congestion rate. However, the study did not observe any difference in the rate of mortality and rehospitalization due to heart failure between the two groups.
The trial included 519 patients that had been diagnosed with acute decompensated heart failure and have been using either 40 mg of furosemide, 1 mg of bumetanide, or 20 mg of torasemide. These patients expressed at least one clinical sign of volume overload - edema, pleural effusion, or ascites - and had a N-terminal pro–B-type natriuretic peptide (NT-proBNP) level > 1000 pg/mL or a B-type natriuretic peptide level > 250 pg/mL. Patients in the intervention group were given daily intravenous bolus of acetazolamide, 500 mg. Those in the intervention group were appropriately matched with those in the control group that were using placebo. The study found that patients who received intravenous acetazolamide are 46% more likely to achieve successful decongestion than those who received placebo. In addition, those in the intervention group experience a faster drop in congestion rate. However, the study did not observe any difference in the rate of mortality and rehospitalization due to heart failure between the two groups.