The oral vasopressin-2 receptor antagonist tolvaptan causes aquaresis in patients with volume overload, potentially facilitating decongestion and improving the clinical course of patients with acute heart failure (AHF).To address the acute use of tolvaptan to improve congestion in AHF, we conducted the Targeting Acute Congestion with Tolvaptan in Congestive Heart Failure (TACTICS-HF, NCT01644331) study.TACTICS-HF randomized patients within 24 hours of AHF presentation in a prospective, double blind, placebo-controlled trial. Patients were eligible regardless of ejection fraction, and were randomized to either 30 mg of tolvaptan or placebo given at 0, 24, and 48 hours, with a fixed-dose furosemide regimen as background therapy. The primary endpoint was the proportion of patients considered responders at 24 hours. Secondary endpoints included symptom improvement, changes in renal function, and clinical events.A total of 257 patients were randomized. Dyspnea relief by Likert scale was similar between tolvaptan and placebo at 8 hours (25
作者:G Michael, Felker;Robert J, Mentz;Robert, Cole;Kirkwood F, Adams;Gregory F, Egnaczyk;Mona, Fiuzat;Chetan B, Patel;Melvin, Echols;Michel G, Khouri;James M, Tauras;Divya, Gupta;Pamela, Monds;Rhonda, Roberts;Christopher M, O'Connor
来源:Journal of the American College of Cardiology 2016 年