TACTIC-HF: Sequential Diuretic Strategies in Ambulatory Worsening Heart Failure
60 participantsStarted 2026-06-15
Plain-language 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. intravenous furosemide alone,
2. intravenous furosemide combined with oral acetazolamide, and
3. intravenous furosemide combined with oral hydrochlorothiazide.
The primary objective is to compare short-term natriuretic response between strategies. Secondary objectives include assessment of urine output, congestion parameters, and renal/electrolyte safety.
Each participant will undergo repeated outpatient treatment sessions separated by washout periods, with standardized clinical and laboratory monitoring performed during each visit.
The study aims to evaluate pragmatic and clinically applicable ambulatory decongestion strategies using approved therapies commonly available in real-world practice.
Who can participate
Age range
18 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* 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
Exclusion Criteria:
* 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
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1This trial is testing different diuretic strategies in ambulatory worsening heart failure — does my current heart failure management mean I'd be a candidate to even consider this kind of outpatient diuretic approach, or would I need inpatient treatment first?
2The main thing this trial is measuring is urinary sodium excretion at 6 hours — can you explain why that's an important marker for heart failure, and what it would mean for me if my results were high or low?
3Since this trial hasn't started recruiting yet, how long might it be before it opens, and is there a comparable study already underway that might be worth looking into in the meantime?
4This is a Phase 4 trial, which I understand means the drugs being tested are already approved — does that mean we have a clearer sense of their safety profile compared to earlier-phase trials, and are there any risks specific to the way these diuretics are being sequenced or combined here?
5If I'm not able to participate in this trial once it opens, are there existing standard-of-care diuretic strategies you'd recommend for my situation that are similar to what this study is investigating?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.