Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/40132
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | MARTENS, Pieter | - |
dc.contributor.author | VERBRUGGE, Frederik | - |
dc.contributor.author | DAUW, Jeroen | - |
dc.contributor.author | NIJST, Petra | - |
dc.contributor.author | MEEKERS, Evelyne | - |
dc.contributor.author | Augusto Jr, Silvio Nunes | - |
dc.contributor.author | Ter Maaten, Jozine M. | - |
dc.contributor.author | HEYLEN, Line | - |
dc.contributor.author | Damman, Kevin | - |
dc.contributor.author | Mebazaa, Alexandre | - |
dc.contributor.author | Filippatos, Gerasimos | - |
dc.contributor.author | Ruschitzka, Frank | - |
dc.contributor.author | Tang, Wai Hong Wilson | - |
dc.contributor.author | DUPONT, Matthias | - |
dc.contributor.author | MULLENS, Wilfried | - |
dc.date.accessioned | 2023-05-24T06:16:30Z | - |
dc.date.available | 2023-05-24T06:16:30Z | - |
dc.date.issued | 2023 | - |
dc.date.submitted | 2023-05-23T09:58:57Z | - |
dc.identifier.citation | EUROPEAN HEART JOURNAL, | - |
dc.identifier.issn | 0195-668X | - |
dc.identifier.uri | http://hdl.handle.net/1942/40132 | - |
dc.description.abstract | Aims Acetazolamide inhibits proximal tubular sodium and bicarbonate re-absorption and improved decongestive response in acute heart failure in the ADVOR trial. It is unknown whether bicarbonate levels alter the decongestive response to acetazolamide. Methods and results This is a sub-analysis of the randomized, double-blind, placebo-controlled ADVOR trial that randomized 519 patients with acute heart failure and volume overload in a 1:1 ratio to intravenous acetazolamide (500 mg/day) or matching placebo on top of standardized intravenous loop diuretics (dose equivalent of twice oral maintenance dose). The primary endpoint was complete decongestion after 3 days of treatment (morning of day 4). Impact of baseline HCO3 levels on the treatment effect of acetazolamide was assessed. : Of the 519 enrolled patients, 516 (99.4%) had a baseline HCO3 measurement. Continuous HCO3 modelling illustrated a higher proportional treatment effect for acetazolamide if baseline HCO3 >= 27 mmol/l. A total of 234 (45%) had a baseline HCO3 >= 27 mmol/l. Randomization towards acetazolamide improved decongestive response over the entire range of baseline HCO3- levels (P = 0.004); however, patients with elevated baseline HCO3 exhibited a significant higher response to acetazolamide [primary endpoint: no vs. elevated HCO3; OR 1.37 (0.79-2.37) vs. OR 2.39 (1.35-4.22), P-interaction = 0.065), with higher proportional diuretic and natriuretic response (both P-interaction < 0.001), greater reduction in congestion score on consecutive days (treatment x time by HCO3-interaction <0.001) and length of stay (P-interaction = 0.019). The larger proportional treatment effect was mainly explained by the development of diminished decongestive response in the placebo arm (loop diuretics only), both with regard to reaching the primary endpoint of decongestion as well as reduction in congestion score. Development of elevated HCO3 further worsened decongestive response in the placebo arm (P-interaction = 0.041). A loop diuretic only strategy was associated with an increase in the HCO3 during the treatment phase which was prevented by acetazolamide (day 3: placebo 74.8% vs. acetazolamide 41.3%, P < 0.001). Conclusion Acetazolamide improves decongestive response over the entire range of HCO3- levels; however, the treatment response is magnified in patients with baseline or loop diuretic-induced elevated HCO3 (marker of proximal nephron NaHCO3 retention) by specifically counteracting this component of diuretic resistance. | - |
dc.description.sponsorship | This study (KCE-17001) is an independent research funded by Belgian Health Care Knowledge Centre under the KCE Trials Program. The views expressed in this publication are those of the author(s) and not necessarily those of Belgian Health Care Knowledge Centre which did not influence the analysis or reporting of the trial. P.M. is supported by a grant from the Belgian American Educational Foundation (BAEF) and by the Frans Van de Werf Fund. | - |
dc.language.iso | en | - |
dc.publisher | OXFORD UNIV PRESS | - |
dc.rights | The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com | - |
dc.subject.other | Acute heart failure | - |
dc.subject.other | Decongestion | - |
dc.subject.other | Acetazolamide | - |
dc.subject.other | Diuresis | - |
dc.subject.other | Natriuresis | - |
dc.title | Pre-treatment bicarbonate levels and decongestion by acetazolamide: the ADVOR trial | - |
dc.type | Journal Contribution | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | Mullens, W (corresponding author), Ziekenhuis Oost Limburg AV, Dept Cardiol, Schiepse bos 6, B-3600 Genk, Belgium. | - |
dc.description.notes | wilfried.mullens@zol.be | - |
local.publisher.place | GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
local.bibliographicCitation.status | Early view | - |
dc.identifier.doi | 10.1093/eurheartj/ehad236 | - |
dc.identifier.pmid | 37138385 | - |
dc.identifier.isi | 000979872700001 | - |
dc.contributor.orcid | Damman, Kevin/0000-0003-0190-2228; Heylen, Line/0000-0002-4595-0195; | - |
dc.contributor.orcid | Martens, Pieter/0000-0002-6036-2113 | - |
dc.identifier.eissn | 1522-9645 | - |
local.provider.type | wosris | - |
local.description.affiliation | [Martens, Pieter; Tang, Wai Hong Wilson] Cleveland Clin, Heart Vasc & Thorac Inst, Dept Cardiovasc Med, Cleveland, OH USA. | - |
local.description.affiliation | [Martens, Pieter; Dauw, Jeroen; Nijst, Petra; Meekers, Evelyne; Dupont, Matthias; Mullens, Wilfried] Ziekenhuis Oost Limburg AV, Dept Cardiol, Schiepse bos 6, B-3600 Genk, Belgium. | - |
local.description.affiliation | [Verbrugge, Frederik H.; Meekers, Evelyne] Univ Hosp Brussels, Ctr Cardiovasc Dis, Jette, Belgium. | - |
local.description.affiliation | [Verbrugge, Frederik H.] Vrije Univ Brussel, Fac Med & Pharm, Jette, Belgium. | - |
local.description.affiliation | [Dauw, Jeroen; Mullens, Wilfried] Hasselt Univ, Fac Med & Life Sci, Martelarenlaan 42, B-3500 Hasselt, Belgium. | - |
local.description.affiliation | [Augusto Jr, Silvio Nunes] Cleveland Clin, Lerner Res Inst, Cardiovasc & Metab Sci, Cleveland, OH USA. | - |
local.description.affiliation | [Ter Maaten, Jozine M.; Damman, Kevin] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands. | - |
local.description.affiliation | [Heylen, Line] Ziekenhuis Oost Limburg AV, Dept Nefrol, Genk, Belgium. | - |
local.description.affiliation | [Mebazaa, Alexandre] Univ Paris Cite, AP HP, Dept Med, Inserm MASCOT, Paris, France. | - |
local.description.affiliation | [Filippatos, Gerasimos] Natl & Kapodistrian Univ Athens, Athens Univ Hosp Attikon, Dept Cardiol, Athens, Greece. | - |
local.description.affiliation | [Ruschitzka, Frank] Univ Heart Ctr, Univ Hosp Zurich, Dept Cardiol, Zurich, Switzerland. | - |
local.description.affiliation | [Ruschitzka, Frank] Univ Zurich, Zurich, Switzerland. | - |
local.uhasselt.international | yes | - |
item.fulltext | With Fulltext | - |
item.accessRights | Restricted Access | - |
item.fullcitation | MARTENS, Pieter; VERBRUGGE, Frederik; DAUW, Jeroen; NIJST, Petra; MEEKERS, Evelyne; Augusto Jr, Silvio Nunes; Ter Maaten, Jozine M.; HEYLEN, Line; Damman, Kevin; Mebazaa, Alexandre; Filippatos, Gerasimos; Ruschitzka, Frank; Tang, Wai Hong Wilson; DUPONT, Matthias & MULLENS, Wilfried (2023) Pre-treatment bicarbonate levels and decongestion by acetazolamide: the ADVOR trial. In: EUROPEAN HEART JOURNAL,. | - |
item.contributor | MARTENS, Pieter | - |
item.contributor | VERBRUGGE, Frederik | - |
item.contributor | DAUW, Jeroen | - |
item.contributor | NIJST, Petra | - |
item.contributor | MEEKERS, Evelyne | - |
item.contributor | Augusto Jr, Silvio Nunes | - |
item.contributor | Ter Maaten, Jozine M. | - |
item.contributor | HEYLEN, Line | - |
item.contributor | Damman, Kevin | - |
item.contributor | Mebazaa, Alexandre | - |
item.contributor | Filippatos, Gerasimos | - |
item.contributor | Ruschitzka, Frank | - |
item.contributor | Tang, Wai Hong Wilson | - |
item.contributor | DUPONT, Matthias | - |
item.contributor | MULLENS, Wilfried | - |
crisitem.journal.issn | 0195-668X | - |
crisitem.journal.eissn | 1522-9645 | - |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
Pre-treatment bicarbonate levels and decongestion by acetazolamide_ the ADVOR trial.pdf Restricted Access | Published version | 895.18 kB | Adobe PDF | View/Open Request a copy |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.