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The evidence base is much smaller for treatment of acute decompensated heart failure (ADHF) than for treatment of chronic heart failure. Now, researchers have conducted three randomized, controlled, manufacturer-sponsored studies of tolvaptan, a selective vasopressin V2-receptor antagonist: two identical trials of its efficacy and safety in short-term management of ADHF, and a larger combined trial of its long-term effects on clinical outcomes.
Collectively, the trials involved 4133 adults (LV ejection fractions ≤40%) who were hospitalized for worsening congestive heart failure. Participants were randomized to receive tolvaptan (30 mg daily) or placebo for at least 60 days. Both groups also received standard HF therapy.
In the short term (by …