TY - JOUR
T1 - Acetazolamide in Decompensated Heart Failure with Volume Overload trial (ADVOR)
T2 - baseline characteristics
AU - Mullens, Wilfried
AU - Dauw, Jeroen
AU - Martens, Pieter
AU - Meekers, Evelyne
AU - Nijst, Petra
AU - Verbrugge, Frederik H.
AU - Chenot, Fabien
AU - Moubayed, Samer
AU - Dierckx, Riet
AU - Blouard, Philippe
AU - Derthoo, David
AU - Smolders, Walter
AU - Ector, Bavo
AU - Hulselmans, Michaël
AU - Lochy, Stijn
AU - Raes, David
AU - Van Craenenbroeck, Emeline
AU - Vandekerckhove, Hans
AU - Hofkens, Pieter Jan
AU - Goossens, Kathleen
AU - Pouleur, Anne Catherine
AU - De Ceuninck, Michel
AU - Gabriel, Laurence
AU - Timmermans, Philippe
AU - Prihadi, Edgard A.
AU - Van Durme, Frederik
AU - Depauw, Michel
AU - Vervloet, Delphine
AU - Viaene, Els
AU - Vachiery, Jean Luc
AU - Tartaglia, Katrien
AU - ter Maaten, Jozine M.
AU - Bruckers, Liesbeth
AU - Droogne, Walter
AU - Troisfontaines, Pierre
AU - Damman, Kevin
AU - Lassus, Johan
AU - Mebazaa, Alexandre
AU - Filippatos, Gerasimos
AU - Ruschitzka, Frank
AU - Dupont, Matthias
N1 - Funding Information:
This study (KCE‐17001) is an independent research funded by Belgian Health Care Knowledge Centre under the KCE Trials Programme. The views expressed in this publication are those of the author and not necessarily those of Belgian Health Care Knowledge Centre.
Publisher Copyright:
© 2022 European Society of Cardiology.
PY - 2022/10/9
Y1 - 2022/10/9
N2 - 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.
AB - 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.
KW - Acetazolamide
KW - Acute heart failure
KW - Congestion
KW - Diuretics
KW - Randomized controlled trial
KW - Volume overload
U2 - 10.1002/ejhf.2587
DO - 10.1002/ejhf.2587
M3 - Article
C2 - 35733283
AN - SCOPUS:85133922452
SN - 1388-9842
VL - 24
SP - 1601
EP - 1610
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 9
ER -