TACTIC-HF: Sequential Diuretic Strategies in Ambulatory Worsening Heart Failure
ConditionAcute Heart Failure (AHF)
Trial statusNot yet recruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexAll
Age18+
SponsorLucrecia Maria Burgos
About this trial
TACTIC-HF is a prospective randomized crossover trial designed to compare three ambulatory diuretic strategies in patients with worsening heart failure treated in a specialized heart failure day-hospital program.
Participants will receive sequential treatment with:
1. intravenous furosemide alone, 2. intravenous furosemide combined with oral acetazolamide, and 3. intravenous furosemide combined with oral hydrochlorothiazide.
The primary objective is to compare short-term natriuretic response between strategies. Secondary objectives include assessment of urine output, congestion parameters, and renal/electrolyte safety.
Each participant will undergo repeated outpatient treatment sessions separated by washout periods, with standardized clinical and laboratory monitoring performed during each visit.
The study aims to evaluate pragmatic and clinically applicable ambulatory decongestion strategies using approved therapies commonly available in real-world practice.
Eligibility criteria
Qualifiers
Age ≥18 years Chronic heart failure diagnosis according to current guideline definitions Ambulatory worsening heart failure requiring intravenous diuretic therapy in a specialized outpatient setting Evidence of clinical or objective congestion Chronic outpatient loop diuretic therapy Ability to comply with study procedures Written informed consent
Disqualifiers
Hemodynamic instability or cardiogenic shock Requirement for immediate hospitalization Acute coronary syndrome, active infection, pulmonary embolism, or uncontrolled arrhythmia Severe electrolyte abnormalities Advanced renal failure requiring dialysis Pregnancy or breastfeeding Contraindication or allergy to study medications Current treatment with acetazolamide or thiazide diuretics Any condition that, in the opinion of the investigators, would make study participation unsafe or interfere with study procedures
Trial design
Treatments tested in this trial
- Intravenous furosemide bolus injections
- ACETAZOLAMIDE oral capsule
- Hydrochlorothiazide (HCT)
Treatment groups
60 Participants
are divided into 3 treatment groupsLocations
Sponsors and collaborators
Lucrecia Maria Burgos
Lead sponsor
Instituto Cardiovascular de Buenos Aires
Sponsor institution
Source ClinicalTrials.gov