{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:58:41Z","timestamp":1783490321214,"version":"3.55.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T00:00:00Z","timestamp":1683676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T00:00:00Z","timestamp":1683676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100019353","name":"Belgian Health Care Knowledge Centre","doi-asserted-by":"publisher","award":["KCE-17001"],"award-info":[{"award-number":["KCE-17001"]}],"id":[{"id":"10.13039\/501100019353","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019353","name":"Belgian Health Care Knowledge Centre","doi-asserted-by":"publisher","award":["KCE\u201017001"],"award-info":[{"award-number":["KCE\u201017001"]}],"id":[{"id":"10.13039\/501100019353","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Acetazolamide, an inhibitor of proximal tubular sodium reabsorption, leads to more effective decongestion in acute heart failure (AHF). It is unknown whether acetazolamide alters serum sodium and potassium levels on top of loop diuretics and if baseline values modify the treatment effect of acetazolamide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This is a pre-specified sub-analysis of the ADVOR trial that randomized 519 patients with AHF and volume overload in a 1:1 ratio to intravenous acetazolamide or matching placebo on top of standardized intravenous loop diuretics. Mean potassium and sodium levels at randomization were 4.2\u2009\u00b1\u20090.6 and 139\u2009\u00b1\u20094\u2009mmol\/L in the acetazolamide arm versus 4.2\u2009\u00b1\u20090.6 and 140\u2009\u00b1\u20094\u2009mmol\/L in the placebo arm. Hypokalaemia (&amp;lt;3.5\u2009mmol\/L) on admission was present in 44 (9%) patients and hyponatraemia (\u2264135\u2009mmol\/L) in 82 (16%) patients. After 3\u2009days of treatment, 44 (17%) patients in the acetazolamide arm and 35 (14%) patients in the placebo arm developed hyponatraemia (p\u2009=\u20090.255). Patients randomized to acetazolamide demonstrated a slight decrease in mean potassium levels during decongestion, which was non-significant over time (p\u2009=\u20090.053) and had no significant impact on hypokalaemia incidence (p\u2009=\u20090.061). Severe hypokalaemia (&amp;lt;3.0\u2009mmol\/L) occurred in only 7 (1%) patients, similarly distributed between the two treatment arms (p\u2009=\u20090.676). Randomization towards acetazolamide improved decongestive response irrespective of baseline serum sodium and potassium levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Acetazolamide on top of standardized loop diuretic therapy does not lead to clinically important hypokalaemia or hyponatraemia and improves decongestion over the entire range of baseline serum potassium and sodium levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2863","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:19:12Z","timestamp":1681690752000},"page":"1310-1319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Sodium and Potassium Changes During Decongestion with Acetazolamide \u2013 A Pre-Specified Analysis from the ADVOR Trial"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5615-3191","authenticated-orcid":false,"given":"Sebastiaan","family":"Dhont","sequence":"first","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg A.V , Genk ,","place":["Belgium"]},{"name":"Hasselt University , Diepenbeek\/Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Martens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg A.V , Genk ,","place":["Belgium"]},{"name":"Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyne","family":"Meekers","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg A.V , Genk ,","place":["Belgium"]},{"name":"Hasselt University , Diepenbeek\/Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"Dauw","sequence":"additional","affiliation":[{"name":"Hasselt University , Diepenbeek\/Hasselt ,","place":["Belgium"]},{"name":"Department of Cardiology, AZ Sint-Lucas , Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik H.","family":"Verbrugge","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Diseases, University Hospital Brussels , Jette ,","place":["Belgium"]},{"name":"Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel , Jette ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Nijst","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg A.V , Genk ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozine M.","family":"ter Maaten","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Damman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Mebazaa","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Inserm MASCOT, APHP , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Attikon University Hospital , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Ruschitzka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center, University Hospital Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.H. 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