Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC Trial

12 p.

Detalhes bibliográficos
Autores: Sánchez Marteles, Marta, Garcés Horna, Vanesa, Morales Rull, José Luis, Casado, Jesús, Carrera Izquierdo, Margarita, Conde Martel, Alicia, Dávila Ramos, Melitón Francisco, Llácer Iborra, Pau, Salamanca Bautista, Prado, Ruiz Ortega, Raúl, Aramburu Bodas, Óscar, Formiga, Francesc, Manzano Espinosa, Luis|||0000-0002-0472-1820, Carles Trullàs, Joan
Formato: artículo
Fecha de publicación:2024
País:España
Recursos:Universidad de Alcalá (UAH)
Repositorio:e_Buah Biblioteca Digital Universidad de Alcalá
Idioma:inglés
OAI Identifier:oai:ebuah.uah.es:10017/64503
Acesso em linha:http://hdl.handle.net/10017/64503
https://dx.doi.org/10.1016/j.jchf.2024.05.006
Access Level:acceso abierto
Palavra-chave:Acute heart failure
Diuretics
Hydrochlorothiazide
Left ventricular ejection fraction
Thiazides
Medicina
Medicine
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spelling Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC TrialSánchez Marteles, MartaGarcés Horna, VanesaMorales Rull, José LuisCasado, JesúsCarrera Izquierdo, MargaritaConde Martel, AliciaDávila Ramos, Melitón FranciscoLlácer Iborra, PauSalamanca Bautista, PradoRuiz Ortega, RaúlAramburu Bodas, ÓscarFormiga, FrancescManzano Espinosa, Luis|||0000-0002-0472-1820Carles Trullàs, JoanAcute heart failureDiureticsHydrochlorothiazideLeft ventricular ejection fractionThiazidesMedicinaMedicine12 p.Background: The addition of hydrochlorothiazide (HCTZ) to furosemide in the CLOROTIC (Combining Loop with Thiazide Diuretics for Decompensated Heart Failure) trial improved the diuretic response in patients with acute heart failure (AHF). Objectives: This work aimed to evaluate if these results differ across the spectrum of left ventricular ejection fraction (LVEF). Methods: This post hoc analysis of the randomized, double-blind, placebo-controlled CLOROTIC trial enrolled 230 patients with AHF to receive either HCTZ or a placebo in addition to an intravenous furosemide regimen. The influence of LVEF on primary and secondary outcomes was evaluated. Results: The median LVEF was 55%: 166 (72%) patients had LVEF >40%, and 64 (28%) had LVEF ?40%. Patients with a lower LVEF were younger, more likely to be male, had a higher prevalence of ischemic heart disease, and had higher natriuretic peptide levels. The addition of HCTZ to furosemide was associated with the greatest weight loss at 72 of 96 hours, better metrics of diuretic response, and greater 24-hour diuresis compared with placebo, with no significant differences according to the LVEF category (using 2 LVEF cutoff points: 40% and 50%) or LVEF as a continuous variable (all P values were insignificant). There were no significant differences observed with the addition of HCTZ in terms of mortality, rehospitalizations, or safety endpoints (impaired renal function, hyponatremia, and hypokalemia) among the 2 LVEF groups (all P values were insignificant). Conclusions: Adding HCTZ to intravenous furosemide seems to be effective strategy for improving diuretic response in AHF without treatment effect modification according to baseline LVEF. (Combining Loop with Thiazide Diuretics for Decompensated Heart Failure [CLOROTIC], NCT01647932; Randomized, double blinded, multicenter study, to assess Safety and Efficacy of the Combination of Loop With Thiazide-type Diuretics vs Loop diuretics with placebo in Patients With Decompensated, EudraCT Number 2013-001852-36).Grupo de Trabajo de Insuficiencia Cardiaca y Fibrilación Auricular de la Sociedad Española de Medicina Interna20242024-10-0120242024-10-0120252025-10-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10017/64503https://dx.doi.org/10.1016/j.jchf.2024.05.00638934966reponame:e_Buah Biblioteca Digital Universidad de Alcaláinstname:Universidad de Alcalá (UAH)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ebuah.uah.es:10017/645032026-06-18T11:13:07Z
dc.title.none.fl_str_mv Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC Trial
title Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC Trial
spellingShingle Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC Trial
Sánchez Marteles, Marta
Acute heart failure
Diuretics
Hydrochlorothiazide
Left ventricular ejection fraction
Thiazides
Medicina
Medicine
title_short Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC Trial
title_full Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC Trial
title_fullStr Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC Trial
title_full_unstemmed Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC Trial
title_sort Combining loop and thiazide diuretics across the left ventricular ejection fraction spectrum: The CLOROTIC Trial
dc.creator.none.fl_str_mv Sánchez Marteles, Marta
Garcés Horna, Vanesa
Morales Rull, José Luis
Casado, Jesús
Carrera Izquierdo, Margarita
Conde Martel, Alicia
Dávila Ramos, Melitón Francisco
Llácer Iborra, Pau
Salamanca Bautista, Prado
Ruiz Ortega, Raúl
Aramburu Bodas, Óscar
Formiga, Francesc
Manzano Espinosa, Luis|||0000-0002-0472-1820
Carles Trullàs, Joan
author Sánchez Marteles, Marta
author_facet Sánchez Marteles, Marta
Garcés Horna, Vanesa
Morales Rull, José Luis
Casado, Jesús
Carrera Izquierdo, Margarita
Conde Martel, Alicia
Dávila Ramos, Melitón Francisco
Llácer Iborra, Pau
Salamanca Bautista, Prado
Ruiz Ortega, Raúl
Aramburu Bodas, Óscar
Formiga, Francesc
Manzano Espinosa, Luis|||0000-0002-0472-1820
Carles Trullàs, Joan
author_role author
author2 Garcés Horna, Vanesa
Morales Rull, José Luis
Casado, Jesús
Carrera Izquierdo, Margarita
Conde Martel, Alicia
Dávila Ramos, Melitón Francisco
Llácer Iborra, Pau
Salamanca Bautista, Prado
Ruiz Ortega, Raúl
Aramburu Bodas, Óscar
Formiga, Francesc
Manzano Espinosa, Luis|||0000-0002-0472-1820
Carles Trullàs, Joan
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Acute heart failure
Diuretics
Hydrochlorothiazide
Left ventricular ejection fraction
Thiazides
Medicina
Medicine
topic Acute heart failure
Diuretics
Hydrochlorothiazide
Left ventricular ejection fraction
Thiazides
Medicina
Medicine
description 12 p.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024-10-01
2024
2024-10-01
2025
2025-10-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10017/64503
https://dx.doi.org/10.1016/j.jchf.2024.05.006
38934966
url http://hdl.handle.net/10017/64503
https://dx.doi.org/10.1016/j.jchf.2024.05.006
identifier_str_mv 38934966
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:e_Buah Biblioteca Digital Universidad de Alcalá
instname:Universidad de Alcalá (UAH)
instname_str Universidad de Alcalá (UAH)
reponame_str e_Buah Biblioteca Digital Universidad de Alcalá
collection e_Buah Biblioteca Digital Universidad de Alcalá
repository.name.fl_str_mv
repository.mail.fl_str_mv
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