Acetazolamide Tolerance in Acute Decompensated Heart Failure: An Observational Study

Area of Science:

• Cardiology
• Pharmacology

Background:

• Acetazolamide (ACZ), a carbonic anhydrase inhibitor, is increasingly used for its diuretic effects in acute heart failure (HF).
• Limited safety data exists for ACZ in hospitalized HF patients, particularly when combined with standard diuretic therapy.

Purpose of the Study:

• To evaluate the in-hospital safety of acetazolamide (ACZ) when added to intravenous furosemide for acute heart failure (HF).
• To compare adverse events between patients receiving ACZ plus furosemide and those receiving furosemide alone.

Main Methods:

• A monocentric observational prospective study conducted in a cardiology department.
• Compared adverse events (hypotension, metabolic acidosis, hypokalemia, renal events) in 28 patients treated with ACZ + furosemide versus 30 patients treated with furosemide alone.

Main Results:

• Patients receiving ACZ were younger and had better baseline renal function.
• No significant differences were observed in the incidence of hypotension, renal events, or severe hypokalemia between the ACZ and control groups.
• No severe metabolic acidosis was reported in either group.

Conclusions:

• The addition of acetazolamide to furosemide in acute heart failure management demonstrated a comparable safety profile to furosemide monotherapy.
• Further observational studies are warranted to confirm ACZ safety in diverse HF populations, especially the elderly and frail.