ReviewCureus2024
A Systematic Review of Baseline Characteristics of Patients With Successful Decongestion on Combination Diuretic Therapy in Acute Decompensated Heart Failure (ADHF).
Review in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- A Contemporary Perspective on Long-Term Complications of Bariatric Surgery.Obesity surgery · 2026Review
- Heart Failure in Older Patients: An Update.Journal of clinical medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute decompensated heart failure (ADHF) often necessitates combination diuretic therapy when patients develop resistance to loop diuretics alone. Understanding baseline characteristics predictive of successful decongestion is essential for tailoring treatment strategies. This systematic review aimed to identify baseline characteristics associated with successful decongestion in ADHF patients undergoing combination diuretic therapy and to evaluate the effectiveness and risks of these therapies. A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with a literature search spanning 2019 to 2024 across PubMed and other databases. Studies included randomized controlled trials (RCTs) and clinical trials focusing on combination diuretic therapy, including thiazide diuretics and acetazolamide. Inclusion criteria emphasized studies reporting baseline characteristics and decongestion outcomes. From 43 initially identified articles, four studies met inclusion criteria. Combination diuretic therapy improved diuretic response and congestion resolution, with specific therapies such as metolazone, hydrochlorothiazide, and tolvaptan showing varying levels of effectiveness. Patients with lower baseline congestion scores, preserved renal function (estimated glomerular filtration rate (eGFR) ≥41 ± 20 mL/min/1.73m²), and higher ejection fractions (≥35%) were more likely to experience favorable outcomes. Risks such as renal impairment occurred more frequently in patients with pre-existing chronic kidney disease (CKD), highlighting the importance of careful monitoring. Notably, metolazone led to greater weight loss (e.g., -6 kg vs. -3 kg) and enhanced diuretic response (940 ± 149 mL/40 mg furosemide/day vs. 541 ± 314 mL). Combination diuretic therapy is effective for improving fluid management in resistant ADHF, but baseline patient characteristics significantly influence outcomes. This review provides novel insights into the role of individualized treatment strategies in optimizing therapy. Future research should focus on validating biomarkers, risk stratification tools, and promising but understudied combinations to improve safety and efficacy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.