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ACETAZOLAMIDE VERSUS THIAZIDES WITH LOOP DIURETICS IN ACUTE DECOMPENSATED HEART FAILURE - Allyson Chan (Board no. 142; South Hall) - Jan 27, 2025 - Abstract #ACC2025ACC_1796; There is no significant difference in average daily net urine output or safety outcomes among patients with ADHF on thiazide and loop, acetazolamide and loop, or all three classes of diuretics, even after adjusting for potential confounders. Further studies are warranted to determine optimal timing and doses of each diuretic when used in combination.
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THE EFFECT OF ELECTRONIC HEALTH RECORD CHOICE ARCHITECTURE ON DIURETIC AUGMENTATION CHOICE (Moderated Poster Theater 02) - Jan 26, 2024 - Abstract #ACC2024ACC_3937; Background: Metolazone and intravenous (IV) chlorothiazide are commonly used for sequential nephron blockade in acute decompensated heart failure (ADHF) with similar efficacy and safety, however, IV chlorothiazide is significantly more expensive... In patients treated for ADHF, modulating the EHR choice architecture through a simple alert significantly reduced chlorothiazide dispenses, providing an avenue for cost reduction in admissions for ADHF.
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Outpatient worsening heart failure managed in dedicated heart failure unit --workload and outcomes (ePosters Station 3) - Feb 28, 2023 - Abstract #HEARTFAILURE2023HEART_FAILURE_909; This ongoing prospective analysis of WHF managed in an outpatient heart failure unit underlines that while the majority can be settled without the need for hospitalisation, the workload is significant and resource intensive often requiring a combination of different diuretic strategies. Only the minority return to baseline diuretic dose prior to the WHF episode indicating a concerning prognostic trend even in the group successfully managed in the community
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[VIRTUAL] Evaluation of intravenous chlorothiazide use in the setting of acute decompensated heart failure. () - Dec 26, 2020 - Abstract #ASHP2020ASHP_1374; Metolazone has been shown to be non-inferior to chlorothiazide IV in increasing urine output in patients with ADHF. Given these results, we believe there is opportunity to increase utilization of metolazone, as well as potential to reduce institutional drug costs due to the significant cost difference between IV chlorothiazide and metolazone.
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