Diuretic Strategies in Acute Heart Failure and Renal Dysfunction: Conventional vs Carbohydrate Antigen 125-guided Strategy. Clinical Trial Design.
Rev Esp Cardiol (Engl Ed)
; 70(12): 1067-1073, 2017 Dec.
Article
en En, Es
| MEDLINE
| ID: mdl-28341415
ABSTRACT
INTRODUCTION AND OBJECTIVES:
The optimal treatment of patients with acute heart failure (AHF) and cardiorenal syndrome type 1 (CRS-1) is far from being well-defined. Arterial hypoperfusion in concert with venous congestion plays a crucial role in the pathophysiology of CRS-I. Plasma carbohydrate antigen 125 (CA125) has emerged as a surrogate of fluid overload in AHF. The aim of this study was to evaluate the clinical usefulness of CA125 for tailoring the intensity of diuretic therapy in patients with CRS-1.METHODS:
Multicenter, open-label, parallel clinical trial, in which patients with AHF and serum creatinine ≥ 1.4mg/dL on admission will be randomized to a) standard diuretic strategy titration-based on conventional clinical and biochemical evaluation, or b) diuretic strategy based on CA125 high dose if CA125 > 35 U/mL, and low doses otherwise. The main endpoint will be renal function changes at 24 and 72hours after therapy initiation. Secondary endpoints will include a) clinical and biochemical changes at 24 and 72hours, and b) renal function changes and major clinical events at 30 days.RESULTS:
The results of this study will add important knowledge on the usefulness of CA125 for guiding diuretic treatment in CRS-1. In addition, it will pave the way toward a better knowledge of the pathophysiology of this challenging situation.CONCLUSIONS:
We hypothesize that higher levels of CA125 will identify a patient population with CRS-1 who could benefit from the use of a more intense diuretic strategy. Conversely, low levels of this glycoprotein could select those patients who would be harmed by high diuretic doses.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Desequilibrio Hidroelectrolítico
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Clortalidona
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Antígeno Ca-125
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Diuréticos
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Síndrome Cardiorrenal
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Furosemida
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Insuficiencia Cardíaca
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Proteínas de la Membrana
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Acetazolamida
Tipo de estudio:
Clinical_trials
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Etiology_studies
Límite:
Humans
Idioma:
En
/
Es
Revista:
Rev Esp Cardiol (Engl Ed)
Año:
2017
Tipo del documento:
Article
País de afiliación:
España