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Title: | Acetazolamide in Decompensated Heart Failure with Volume Overload trial (ADVOR): baseline characteristics | Authors: | MULLENS, Wilfried DAUW, Jeroen Martens, Pieter MEEKERS, Evelyne NIJST, Petra VERBRUGGE, Frederik Chenot, Fabien Moubayed, Samer Dierckx , Riet Blouard, Philippe Derthoo, David Smolders, Walter Ector , Bavo Hulselmans, Michael Lochy, Stijn Raes , David Van Craenenbroeck, Emeline Vandekerckhove, Hans Hofkens, Pieter-Jan Goossens, Kathleen Pouleur, Anne-Catherine De Ceuninck, Michel Gabriel, Laurence Timmermans, Philippe Prihadi, Edgard A. Van Durme, Frederik Depauw, Michel Vervloet, Delphine Viaene, Els Vachiery, Jean-Luc Tartaglia, Katrien Ter Maaten, Jozine M. BRUCKERS, Liesbeth Droogne, Walter Troisfontaines, Pierre Damman, Kevin Lassus, Johan Mebazaa, Alexandre Filippatos, Gerasimos Ruschitzka, Frank DUPONT, Matthias |
Issue Date: | 2022 | Publisher: | WILEY | Source: | European journal of heart failure, | Status: | Early view | Abstract: | Aims To describe the baseline characteristics of participants in the Acetazolamide in Decompensated Heart Failure with Volume Overload (ADVOR) trial and compare these with other contemporary diuretic trials in acute heart failure (AHF). Methods and results ADVOR recruited 519 patients with AHF, clinically evident volume overload, elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) and maintenance loop diuretic therapy prior to admission. All participants received standardized loop diuretics and were randomized towards once daily intravenous acetazolamide (500 mg) versus placebo, stratified according to study centre and left ventricular ejection fraction (LVEF) (<= 40% vs. >40%). The primary endpoint was successful decongestion assessed by a dedicated score indicating no more than trace oedema and no other signs of congestion after three consecutive days of treatment without need for escalating treatment. Mean age was 78 years, 63% were men, mean LVEF was 43%, and median NT-proBNP 6173 pg/ml. The median clinical congestion score was 4 with an EuroQol-5 dimensions health utility index of 0.6. Patients with LVEF <= 40% were more often male, had more ischaemic heart disease, higher levels of NT-proBNP and less atrial fibrillation. Compared with diuretic trials in AHF, patients enrolled in ADVOR were considerably older with higher NT-proBNP levels, reflecting the real-world clinical situation. Conclusion ADVOR is the largest randomized diuretic trial in AHF, investigating acetazolamide to improve decongestion on top of standardized loop diuretics. The elderly enrolled population with poor quality of life provides a good representation of the real-world AHF population. The pragmatic design will provide novel insights in the diuretic treatment of patients with AHF. | Notes: | Mullens, W (corresponding author), Ziekenhuis Oost Limburg, Schiepse Bos 6, B-3600 Genk, Belgium. wilfried.mullens@zol.be |
Keywords: | Acute heart failure;Belgium;Diuretics;5 Grand Hôpital de Charleroi, Charleroi, Belgium;Randomized controlled trial;6 CHU Charleroi, Charleroi, Belgium;7 OLV Hospital, Aalst, Belgium;Acetazolamide;Congestion;8 Clinic Saint-Luc, Bouge, Belgium;Volume overload;9 AZ Groeninge, Kortrijk, Belgium;10 AZ Klina, Brasschaat, Belgium;11 Imelda Hospital, Bonheiden, Belgium;12 Ziekenhuis Maas en Kempen, Maaseik, Belgium;13 GZA Sint-Augustinus, Wilrijk, Belgium;14 Belgium;16 AZ Sint-Lucas, Ghent, Belgium;17 AZ Turnhout, Turnhout, Belgium;18 AZ Nikolaas, Sint-Niklaas, Belgium;19 Cardiovascular Department, Cliniques Universitaires St Luc, Brussels, Belgium;20 AZ Delta, Roeselare, Belgium;21 CHU UCL Namur, Yvoir, Belgium;22 Jessa Hospital, Hasselt, Belgium;23 ZNA Hartcentrum, Antwerpen, Belgium;24 AZ Glorieux, Ronse, Belgium;25 Universitair Ziekenhuis Gent, Ghent, Belgium;26 AZ Maria Middelares, Ghent, Belgium;27 Jan Yperman Hospital, Ieper, Belgium;28 Ziekenhuis Erasme, Brussels, Belgium | Document URI: | http://hdl.handle.net/1942/37977 | ISSN: | 1388-9842 | e-ISSN: | 1879-0844 | DOI: | 10.1002/ejhf.2587 | ISI #: | 000822982700001 | Rights: | 2022 European Society of Cardiology | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2023 |
Appears in Collections: | Research publications |
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