Diuretics are drugs designed to help the kidney flush excess fluid from the body and are a key treatment strategy for heart failure patients with an overload of fluid. While diuretics are a mainstay in clinical practice, there are varying perspectives on which diuretics should be used and the appropriate dosage.
Published in the European Journal of Heart Failure, this secondary analysis of the VICTORIA trial compared the efficacy and outcomes of vericiguat, a drug used to reduce the risk of death and hospitalization in people with chronic heart failure, with the background use of diuretics in patients with worsening heart failure.
The researchers identified a total of 4,974 VICTORIA patients who used loop diuretics (a class of diuretics that interacts with a part of the kidney called the “loop of Henle”), and categorized them into 5 groups based on dosage at the beginning of the study: 0 mg, 1-39mg, 40mg, 41-80mg, and >80mg.
The study results demonstrated a clear progression of risk based on total daily dosage. Patients with higher doses of diuretics were at greater risk of cardiovascular death and heart failure hospitalization, whereas patients with lower doses had a lower risk of these outcomes. The researchers found that the efficacy of vericiguat was maintained across the full range of diuretic dosages, and was not associated with any differential changes in the use of diuretic therapy.
This research was conducted by the VICTORIA study group, and CVC co-authors include Justin Ezekowitz, MBBCh, MSc, Wendimagegn Alemayehu, PhD, Cindy Westerhout, PhD, and Paul W. Armstrong, MD.
