Open AccessUse of acetazolamide in the treatment of patients with refractory congestive heart failure
Author(s) -
Núñez Julio,
Heredia Raquel,
Payá Ana,
Sanchis Ignacio,
Prado Susana,
Miñana Gema,
Santas Enrique,
Espriella Rafael,
Núñez Eduardo,
Sanchis Juan,
BayésGenís Antoni
Publication year - 2018
Publication title -
cardiovascular therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.818
H-Index - 46
eISSN - 1755-5922
pISSN - 1755-5914
DOI - 10.1111/1755-5922.12465
Subject(s) - medicine , acetazolamide , diuretic , heart failure , refractory (planetary science) , ambulatory , renal function , cardiology , astrobiology , physics
Summary Aims Optimal diuretic treatment of patients with refractory congestive heart failure (CHF) remains to be elucidated. In this work, we aimed to evaluate the serial changes of functional class and surrogates of fluid overload (weight and antigen carbohydrate 125) after addition of oral acetazolamide in patients with refractory CHF. Likewise, serial changes in renal function, serum electrolytes and pH were evaluated. Method This is an observational retrospective study in which 25 ambulatory patients with refractory CHF that received acetazolamide in addition to standard intensive diuretic strategy were evaluated. Longitudinal assessment of New York Heart Association (NYHA) functional class and biomarkers was analyzed using joint modelling of longitudinal and survival data. Results All patients showed NYHA class III/IV at baseline. After prescription of acetazolamide, a total of 125 outpatient visits were recorded [median visits per patient: 6 (IQR = 3‐7)] during a median follow‐up of 152 days (IQR = 80‐353). A significant decrease in NYHA class, weight, and antigen carbohydrate 125 was observed. On the other hand, estimated glomerular filtration rate increased over time. No significant changes in systolic blood pressure, serum sodium, potassium, amino‐terminal pro‐brain natriuretic peptide, and pH occurred. Conclusion In a cohort of patients with refractory CHF treated with an intensive diuretic treatment, the addition of acetazolamide was associated with improvement in functional class and surrogates of fluid overload.