Efficacy of acetazolamide and loop diuretics combinatorial therapy in congestive heart failure: A meta-analysis
Bibliographic record
Abstract
Acetazolamide, one of the carbonic anhydrase inhibitors, has been known to improve the efficacy of diuretic therapy in patients with in congestion heart failure. The aim this study was to investigate the effectiveness of acetazolamide when combined with loop diuretics in ameliorating diuresis and natriuresis in congestive heart failure using systematic review and meta-analysis. Randomized controlled trials (RCTs) and cohort studies were searched on PubMed, Scopus, and Embase on March 7, 2023, by using combinations of ‘acetazolamide’, ‘heart failure’ and along with their respective synonyms. The protocol had been registered on PROSPERO (CRD42023409864). The studies must investigate the effect of oral acetazolamide as the add-on to loop diuretic therapy to be included. Successful decongestion, natriuresis, and diuresis were set as the primary outcomes. The quality of the included studies was assessed using the Cochrane risk-of-bias tool for RCTs and Newcastle Ottawa Scale for observational studies. We identified 1176 titles in the initial search, and further reduced to five studies (three RCTs and two cohort studies) after in-depth screening. A total of 625 patients were recruited in the included studies published from 2015 to 2022. Results from meta-analysis revealed that acetazolamide and loop diuretics combination therapy ameliorated natriuresis (n=4; standardized means difference (SMD): 0.65; 95%CI: 0.07–1.24; p=0.03) and diuresis (n=2; SMD: 0.29; 95%CI: 0.12–0.46; p=0.0009) when compared to loop diuretics alone. Acetazolamide and loop diuretics combinatorial therapy is efficacious in alleviating congestion in heart failure patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.018 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.020 | 0.064 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".