Acetazolamide in Decompensated Heart Failure With Volume OveRload (ADVOR)

Exclusion Criteria

• •Concurrent diagnosis of an acute coronary syndrome defined as typical chest pain in addition to a troponin rise above the 99th percentile and/or electrocardiographic changes suggestive of cardiac ischemia
• •History of congenital heart disease requiring surgical correction
• •History of a cardiac transplantation and/or ventricular assist device
• •Systolic blood pressure \<90 mmHg or mean arterial pressure \<65 mmHg at the moment of admission
• •Expected use of intravenous inotropes, vasopressors or nitroprusside during the study. Use of nitrates is allowed only if the patient's systolic blood pressure is \>140 mmHg
• •Estimated glomerular filtration rate \<20 mL/min/1.73m² at screening
• •Use of renal replacement therapy or ultrafiltration at any time before study inclusion
• •Treatment with acetazolamide during the index hospitalization and prior to randomization
• •Exposure to nephrotoxic agents (i.e. contrast dye) anticipated within the next 3 days
• •Use of any non-protocol defined diuretic agent with the exception of mineralocorticoid receptor antagonists. Thiazides, metolazone, indapamide and amiloride should be stopped upon study inclusion. If patient is taking a combination drug including a thiazide-type diuretic, the thiazide-type diuretic should be stopped
• •Current use of sodium-glucose transporter-2 inhibitors
• •Subjects who are pregnant or breastfeeding