Acetazolamide versus metolazone added to usual diuretics for acute decompensated heart failure

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This randomized interventional trial will assign adults hospitalized with acute decompensated heart failure to receive either acetazolamide or metolazone in addition to their standard loop diuretic therapy. The study will measure successful decongestion, in-hospital mortality, and length of hospital stay as primary outcomes, with secondary monitoring of kidney function, electrolyte changes, and overall safety. Participants must have clinical signs of volume overload and elevated natriuretic peptides, and those with end-stage renal disease, severe hypotension, recent use of the study drugs, or pregnancy are excluded. The trial is being conducted at a single center in Bahawalpur, Pakistan, and aims to inform optimal adjunctive diuretic choice in this high-risk population.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Aged 18 years or older.
* Diagnosed with Acute Decompensated Heart Failure (ADHF), with either preserved or reduced ejection fraction (EF).
* At least one clinical sign of volume overload, such as:
* Pleural effusion (confirmed by chest X-ray or ultrasound).
* Oedema or ascites (verified by abdominal ultrasonography).
* Plasma NT-proBNP level \> 1000 pg/mL or BNP level \> 250 ng/mL at screening.
* Receiving at least 40 mg of furosemide as oral maintenance therapy for at least one month prior to the study initiation.

Exclusion Criteria:

* Previous use of acetazolamide or metolazone prior to the study period.
* Known hypersensitivity or allergies to the study drugs (acetazolamide or metolazone) or their components.
* Patients with electrolyte disturbances, especially hypokalemia.
* End-stage renal disease requiring dialysis or GFR \< 20 mL/min/1.73 m².
* Pregnant or breastfeeding women.
* Severe hypotension (systolic blood pressure \< 90 mmHg) or other significant comorbidities like congenital cardiac illness requiring surgery.
* Patients requiring renal replacement therapy during the hospitalization.
* History of significant electrolyte imbalances or acid-base disturbances.

Where it's running

• Quaid e Azam Medical College , bahawalpur
  Chak Eighty-seven -Twelve Left, Punjab Province, Pakistan Recruiting

Study contacts

• Study coordinator: Matiullah Azmoon
• Email: matiullahazmoon@gmail.com
• Phone: 03221639240

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• LY3971297 in heart failure: safety and tolerability in HF with preserved and reduced ejection fraction

  This study tests how well LY3971297 is tolerated and what side effects occur in people with HFpEF or HFrEF.

  Recruiting Phase 1 Eli Lilly and Company · Detroit, Michigan and 11 other locations · NCT07547540

• Exploring the links between oral bacteria, muscle blood flow, and fitness levels

  This study is trying to see how oral bacteria and fitness levels affect blood flow to muscles in people.

  Recruiting University of Virginia · Charlottesville, Virginia · NCT06009276

• Comparing Aortix Device to Diuretics for Acute Heart Failure

  This study is testing whether the Aortix device can help people with acute heart failure who aren't responding to diuretics feel better compared to standard treatment.

  Recruiting at 33 sites Procyrion · Phoenix, Arizona and 49 other locations · NCT05677100

• Investigating heart disease risk factors in psoriasis patients

  This study is trying to see if certain heart-related markers can help predict heart disease risk in people with psoriasis.

  Recruiting Herlev and Gentofte Hospital · Hellerup, Copenhagne · NCT04950218

• Evaluating a noninvasive tissue sensor to detect cardiogenic shock earlier in heart patients

  This pilot, noninvasive study tests whether the NIRSense wearable can help detect deterioration in adults with cardiogenic shock risk due to heart attack or heart failure.

  Recruiting NIRSense Inc. · Weston, Florida · NCT07825363

• BEAT-SHOCK: Baseline Registry for Acute Cardiogenic Shock at Basel

  This registry collects and shares data on adults with cardiogenic shock admitted to University Hospital Basel to help understand how these patients are treated and how they fare.

  Recruiting University Hospital, Basel, Switzerland · Basel, Canton of Basel-City · NCT07643610

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.