{"id":"52de19829ae4","type":"article","url":"https://hartvaat.nl/2019/11/21/diureticastaken-bij-stabiel-mild-hf-zonder-vochtretentie/","title":"Diureticastaken bij stabiel mild HF zonder vochtretentie","title_en":"Short-term diuretic withdrawal in stable outpatients with mild heart failure and no fluid retention receiving optimal therapy: a double-blind, multicentre, randomized trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["acuut-hartfalen","dapa-hf","diuretica","emperor-trials","finearts-hf","hfmref","hfpef","hfref","step-hfpef"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehz554","source_url":"https://doi.org/10.1093/eurheartj/ehz554","authors":["Luis E Rohde","Marciane M Rover","Jose A Figueiredo Neto","Luiz C Danzmann","Eduardo G Bertoldi","Marcus V Simões","Odilson M Silvestre","Antonio L P Ribeiro","Lidia Zytynski Moura","Luis Beck-da-Silva","Debora Prado","Roberto T Sant'Anna","Leonardo H Bridi","André Zimerman","Priscila Raupp da Rosa","Andréia Biolo"],"significance":6,"published":"2019-11-21","source_date":"2019-11-21","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/icd-bij-hartfalen/","https://hartvaat.nl/kennis/hartfalen/vochtstatus-bewaking-hartfalen/"],"congress":"","summary_en":"This study tested short-term diuretic withdrawal in stable outpatients with mild heart failure receiving optimal medical therapy, showing that many patients can safely reduce or stop loop diuretics when well-compensated.","created":"2026-07-03T10:28:16Z","updated":"2026-07-03T18:38:45Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie die het kortdurend staken van diuretica onderzocht bij stabiele poliklinische hartfalenpatiënten met milde symptomen en optimale therapie.","abstract_original":"AIMS: Although loop diuretics are widely used to treat heart failure (HF), there is scarce contemporary data to guide diuretic adjustments in the outpatient setting. METHODS AND RESULTS: In a prospective, randomized and double-blind protocol, we tested the safety and tolerability of withdrawing low-dose furosemide in stable HF outpatients at 11 HF clinics in Brazil. The trial had two blindly adjudicated co-primary outcomes: (i) symptoms assessment quantified as the area under the curve (AUC) of a dyspnoea score on a visual-analogue scale evaluated at 4 time-points (baseline, Day 15, Day 45, and Day 90) and (ii) the proportion of patients maintained without diuretic reuse during follow-up. We enrolled 188 patients (25% females; 59 ± 13 years old; left ventricular ejection fraction = 32 ± 8%) that were randomized to furosemide withdrawal (n = 95) or maintenance (n = 93). For the first co-primary endpoint, no significant difference in patients' assessment of dyspnoea was observed in the comparison of furosemide withdrawal with continuous administration [median AUC 1875 (interquartile range, IQR 383-3360) and 1541 (IQR 474-3124), respectively; P = 0.94]. For the second co-primary endpoint, 70 patients (75.3%) in the withdrawal group and 77 patients (83.7%) in the maintenance group were free of furosemide reuse during follow-up (odds ratio for additional furosemide use with withdrawal 1.69, 95% confidence interval 0.82-3.49; P = 0.16). Heart failure-related events (hospitalizations, emergency room visits, and deaths) were infrequent and similar between groups (P = 1.0). CONCLUSIONS: Diuretic withdrawal did not result in neither increased self-perception of dyspnoea nor increased need of furosemide reuse. Diuretic discontinuation may deserve consideration in stable outpatients with no signs of fluid retention receiving optimal medical therapy. CLINICALTRIALS.GOV IDENTIFIER: NCT02689180."}