Comparing Diuretic Strategies in Hospitalized Heart Failure

Stanford University

Overview

We will conduct a pragmatic randomized trial comparing whether using a combination of two types of diuretics (loop + thiazide) compared with using a single diuretic (loop only) will result in shorter hospital stays for patients hospitalized with heart failure.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Conditions

Heart Failure

Interventions

Loop Diuretics vs. loop + thiazide diureticsDRUG

Participants will receive the diuretic type as determined by the randomized group assignment starting within the first 24 hours of hospital admission and continuing for up to 72 hours. All other treatments are left to the discretion of the treatment team, as this is a pragmatic randomized trial.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Any adult (age ≥18 years) admitted to the Heart Failure Service at Stanford Health Care with an indication for treatment with a diuretic. Exclusion Criteria: 1. admission to the intensive care unit or cardiac care units 2. maintenance dialysis on admission 3. any mechanical circulatory support on admission 4. history of heart transplant 5. allergy / intolerance to loop or thiazide diuretics 6. admission serum sodium \< 125 meq/L (from EPIC) 7. admission serum potassium \< 3.0 meq/L (from EPIC)

Locations (1)

Stanford Health Care

Palo Alto, California, United States

Outcomes

Primary Outcomes

Hospital length of stay

Time frame: During hospitalization up to 90 days

Secondary Outcomes

Composite of all-cause rehospitalizations, emergency department visits, or death in the 30 days after hospital discharge.

Time frame: 30 days

Data from ClinicalTrials.gov

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