Add-on Diuretics in Acute Decompensated Heart Failure
Clinical Study Comparing Empagliflozin, Acetazolamide, and Metolazone as Add-on Therapies to Loop Diuretics in Acute Decompensated Heart Failure
Tanta University
66 participants
Feb 1, 2026
INTERVENTIONAL
Conditions
Summary
The aim of this study is to compare the efficacy and safety of empagliflozin, acetazolamide, and metolazone as add-on therapies to loop diuretics in patients with acute decompensated heart failure.
Eligibility
Inclusion Criteria2
- Male or female patients older than 18 years.
- Hospital admission with clinical diagnosis of acute decompensated heart failure with at least one clinical sign of volume overload (e.g. edema, ascites confirmed by echography or pleural effusion confirmed by chest X-ray or echography).
Exclusion Criteria9
- Type 1 diabetes.
- Chronic kidney disease with estimated glomerular filtration rate (eGFR) \<30 mL/min per 1.73 m² or end-stage kidney failure with the need for chronic dialysis treatment.
- A systolic blood pressure of less than 90 mmHg.
- Cardiogenic shock.
- Receipt of acetazolamide maintenance therapy.
- Receipt of an SGLT2 inhibitor, thiazide, or thiazide-like diuretic in the 48 hrs before randomization.
- Any cause of heart failure leading to decompensation that will need urgent management (eg, acute coronary syndrome, unstable arrhythmias, acute pulmonary embolism).
- Pregnant or breastfeeding women.
- Moderate to severe anemia.
Interventions
Empagliflozin may augment the natriuretic and aquaretic actions of loop diuretics in patients with acute decompensated heart failure and it does not typically cause electrolyte disturbances and has been shown to improve outcomes in patients with heart failure
Acetazolamide can augment the action of loop diuretics in patients with acute decompensated heart failure
Metolazone can augment the action of loop diuretics in patients with acute decompensated heart failure
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07372040