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Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions-Part II: Combination Therapy

Cuthbert, Joe; Clark, Andrew; Cleland, John

Authors

Andrew Clark

John Cleland



Abstract

Purpose of Review Fluid retention or congestion is a major cause of symptoms, poor quality of life, and adverse outcome in patients with heart failure (HF). Despite advances in disease-modifying therapy, the mainstay of treatment for congestion loop diuretics-has remained largely unchanged for 50 years. In these two articles (part I: loop diuretics and part II: combination therapy), we will review the history of diuretic treatment and current trial evidence for different diuretic strategies and explore potential future directions of research. Recent Findings We will assess recent trials, including DOSE, TRANSFORM, ADVOR, CLOROTIC, OSPREY-AHF, and PUSH-AHF, and assess how these may influence current practice and future research. Summary There are few data on which to base diuretic therapy in clinical practice. The most robust evidence is for high-dose loop diuretic treatment over low-dose treatment for patients admitted to hospital with HF, yet this is not reflected in guidelines. There is an urgent need for more and better research on different diuretic strategies in patients with HF.

Citation

Cuthbert, J., Clark, A., & Cleland, J. (2024). Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions-Part II: Combination Therapy. Current Heart Failure Reports, https://doi.org/10.1007/s11897-024-00644-2

Journal Article Type Review
Acceptance Date Jan 3, 2024
Online Publication Date Feb 1, 2024
Publication Date Feb 1, 2024
Deposit Date Feb 1, 2024
Publicly Available Date Feb 6, 2024
Journal Current Heart Failure Reports
Print ISSN 1546-9530
Publisher Springer
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1007/s11897-024-00644-2
Keywords Diuretic treatment; Combination therapy; Loop diuretic; Decompensated HF; Acetazolamide; Thiazide; Digoxin; Steroid; Oral salt; Tolvaptan; Sodium-glucose co-transporter 2 inhibitors
Public URL https://hull-repository.worktribe.com/output/4531056

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0

Copyright Statement
© The Author(s) 2024.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.




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