TACTIC-HF: Sequential Diuretic Strategies in Ambulatory Worsening Heart Failure

NCT07593612 | Not Yet Recruiting Phase 4

• 2 other identifiers: TACTIC-HF2
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

TACTIC-HF is a prospective randomized crossover trial designed to compare three ambulatory diuretic strategies in patients with worsening heart failure treated in a specialized heart failure day-hospital program. Participants will receive sequential treatment with:

1. 1.intravenous furosemide alone,
2. 2.intravenous furosemide combined with oral acetazolamide, and
3. 3.intravenous furosemide combined with oral hydrochlorothiazide.

Conditions

Acute Heart Failure (AHF)

Keywords

worsening heart failure

Outcome Measures

Primary Outcomes (1)

• Total Urinary Sodium Excretion at 6 Hours

  Total urine volume collected during the outpatient treatment session

  6 hours

Study Arms (3)

Intravenous Furosemide

ACTIVE COMPARATOR

Participants receive outpatient intravenous furosemide according to the study protocol during a structured ambulatory treatment session.

Drug: Intravenous furosemide bolus injections

Intravenous Furosemide + Acetazolamide

EXPERIMENTAL

Participants receive outpatient intravenous furosemide combined with oral acetazolamide during a structured ambulatory treatment session

Drug: Intravenous furosemide bolus injections; Drug: ACETAZOLAMIDE oral capsule

Intravenous Furosemide + Hydrochlorothiazide

EXPERIMENTAL

Participants receive outpatient intravenous furosemide combined with oral hydrochlorothiazide during a structured ambulatory treatment session

Drug: Intravenous furosemide bolus injections; Drug: Hydrochlorothiazide (HCT)

Interventions

Intravenous furosemide bolus injections DRUG

Intravenous loop diuretic therapy administered during outpatient treatment sessions according to protocol-defined dosing categories.

Intravenous Furosemide; Intravenous Furosemide + Acetazolamide; Intravenous Furosemide + Hydrochlorothiazide

ACETAZOLAMIDE oral capsule DRUG

Oral acetazolamide administered prior to intravenous loop diuretic therapy during outpatient treatment sessions

Intravenous Furosemide + Acetazolamide

Hydrochlorothiazide (HCT) DRUG

Oral hydrochlorothiazide administered prior to intravenous loop diuretic therapy during outpatient treatment sessions.

Intravenous Furosemide + Hydrochlorothiazide

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥18 years Chronic heart failure diagnosis according to current guideline definitions Ambulatory worsening heart failure requiring intravenous diuretic therapy in a specialized outpatient setting Evidence of clinical or objective congestion Chronic outpatient loop diuretic therapy Ability to comply with study procedures Written informed consent

You may not qualify if:

• Hemodynamic instability or cardiogenic shock Requirement for immediate hospitalization Acute coronary syndrome, active infection, pulmonary embolism, or uncontrolled arrhythmia Severe electrolyte abnormalities Advanced renal failure requiring dialysis Pregnancy or breastfeeding Contraindication or allergy to study medications Current treatment with acetazolamide or thiazide diuretics Any condition that, in the opinion of the investigators, would make study participation unsafe or interfere with study procedures

Sponsors & Collaborators

• Lucrecia Maria Burgos: lead

Related Publications (3)

• Abbo AR, Gruber A, Volis I, Aronson D, Girerd N, Lund Kristensen S, Zukermann R, Alberkant N, Sitnitsky E, Kruger A, Khasis P, Bravo E, Elad B, Helmer Levin L, Caspi O. Diuresis Efficacy in Ambulatory Congested Heart Failure Patients: Intrapatient Comparison of 3 Diuretic Regimens (DEA-HF). JACC Heart Fail. 2024 Aug;12(8):1396-1405. doi: 10.1016/j.jchf.2024.04.014. Epub 2024 May 11.

  PMID: 38739124 BACKGROUND

• Trullas JC, Morales-Rull JL, Casado J, Carrera-Izquierdo M, Sanchez-Marteles M, Conde-Martel A, Davila-Ramos MF, Llacer P, Salamanca-Bautista P, Perez-Silvestre J, Plasin MA, Cerqueiro JM, Gil P, Formiga F, Manzano L; CLOROTIC trial investigators. Combining loop with thiazide diuretics for decompensated heart failure: the CLOROTIC trial. Eur Heart J. 2023 Feb 1;44(5):411-421. doi: 10.1093/eurheartj/ehac689.

  PMID: 36423214 BACKGROUND

• Mullens W, Dauw J, Martens P, Verbrugge FH, Nijst P, Meekers E, Tartaglia K, Chenot F, Moubayed S, Dierckx R, Blouard P, Troisfontaines P, Derthoo D, Smolders W, Bruckers L, Droogne W, Ter Maaten JM, Damman K, Lassus J, Mebazaa A, Filippatos G, Ruschitzka F, Dupont M; ADVOR Study Group. Acetazolamide in Acute Decompensated Heart Failure with Volume Overload. N Engl J Med. 2022 Sep 29;387(13):1185-1195. doi: 10.1056/NEJMoa2203094. Epub 2022 Aug 27.

  PMID: 36027559 BACKGROUND

MeSH Terms

Interventions

Acetazolamide; Hydrochlorothiazide

Intervention Hierarchy (Ancestors)

Thiadiazoles; Thiazoles; Sulfur Compounds; Organic Chemicals; Azoles; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Chlorothiazide; Benzothiadiazines; Sulfonamides; Sulfones; Thiazides; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring

Central Study Contacts

Lucrecia Maria Burgos, MD

CONTACT

541147877500; lburgos@icba.com.ar

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: May 11, 2026
• First Posted: May 18, 2026
• Study Start (Estimated): June 15, 2026
• Primary Completion (Estimated): January 15, 2027
• Study Completion (Estimated): January 15, 2027
• Last Updated: May 18, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share