Zachary Cox

Professor, Lipscomb University| Heart Failure Clinical Pharmacy Specialist, Vanderbilt University Medical Center |

[Zachary Cox @Zac0x]

Read more here:
Assessment of Ototoxicity in Patients With Heart Failure Receiving High-Dose IV Loop Diuretics
https://t.co/W3W4A0rBtU

[Zachary Cox @Zac0x]

Are high dose IV loop diuretics associated with ototoxicity? We investigated this common concern in randomized double-blind trials of contemporary AHF populations with IV furosemide doses up to 500mg.
doi: 10.1001/jamacardio.2026.4913
@JAMACardio @YaleHF @VUMCDiscoveries

[Zachary Cox @Zac0x]

Conclusion: In patients not receiving concomitant ototoxins, short-term exposure to high-dose loop diuretics was not associated with permanent ototoxicity. Concern for ototoxicity should not impede IV diuretic titration when needed to achieve decongestion.

[Jack Pluenneke @JackPluenneke]

Join @Zac0x, @BenWangPharmD, and I as we take a deep dive into alternative decongestion strategies in AHF. Conversation will focus on practical considerations and allow for audience discussion and engagement. Oh yeah, and it’s Free! @HFSA @accpcardprn

[Circ: Heart Failure @CircHF]

A scoping review of HF guideline-directed medical therapy scoring systems highlights major heterogeneity in how GDMT implementation is defined, measured, & applied. Check it out, ahead of print in Circulation: Heart Failure Journal @DouglasLeeMD @nimamogh https://t.co/dZRuxVdESA

[Zachary Cox @Zac0x]

@wbaker0531 @EiranGorodeski We are currently using similar methods for bolus doses up to 500mg of iv furosemide equivalents with a controlled infusion rate in multiple cohorts. Hope to publish this data soon and share the results.

[Zachary Cox @Zac0x]

@wbaker0531 @EiranGorodeski I agree. Infusion rate is an important factor. This data is from the FASTR trial where iv lasix was given as a continuous infusion. This is a big step forward in that high cumulative dose is not associated with ototoxicity measures but doesn’t directly address large bolus doses.

[Zachary Cox @Zac0x]

We randomized patients with diuretic resistance to IV loop dose increase vs adding a thiazide in the LOT-MDR trial. I will present the late-breaking results shortly at #ESCCongress Join us if you are available.

[Zachary Cox @Zac0x]

Our review on drugs and devices for decongestion in #heartfailure is available @NatRevCardiol
https://t.co/PEBIkWfSeC
@LipscombPharmD @YaleHF @kevin_damman

[Nature Reviews Cardiology @NatRevCardiol]

New online! Decongestion in heart failure: medical and device therapies https://t.co/vP4d449EEb

[Journal of Cardiac Failure @JCardFail]

🔥 New brief report describes a first-in-human feasibility study to evaluate the safety/efficacy of the Reprieve System, a bedside fluid mgmnt device that can 1) measure UO
2) semi-auto titrate IV diuretics
3) titrate saline replacement #THT2025

🔗 https://t.co/J4ZDnMZBHd

[Cardiovascular Research Foundation @crfheart]

At #THT2025, experts dive into the complex role of salt in #HeartFailure 🧂, from molecular mechanisms 🧬 to clinical trials 📊 and real-world management 🏥. Don’t miss the latest insights, crucial data, and a debate on salt restriction! ⚖️💡 @mrchrtfaildoc @JanBiegus @zac0x

[Nosheen Reza, MD, MS @noshreza]

A 🕵🏽‍♀️ theme for our session on myocardial recovery vs. remission — drugs, devices, and the interplay of them all with @VarinderKaurRa1 @FilioBillia @Zac0x @docbhardwaj Dr. Joe Rogers and Dr. Jerry Estep

#HFSA2024 @HFSA

[Steve Greene @SJGreene_md]

Costs? Intolerance? Inertia? Other? Primary reason for gaps in #GDMTworks endlessly debated.

🤔What if we had US physicians audit their own patient charts & report *WHY* they didn’t prescribe #GDMT for #HFrEF in each case?

🚨 Results in @JACCJournals

https://t.co/ho6Ah03KJy

[Anju Bhardwaj MD FACC @docbhardwaj]

Join us at kick off sessions #HFSA2024 on
Heart Recovery: Just the Facts, Ma'am!

Looking forward to share thoughts on temporary #MCS & insightful discussions with thought leaders!

📆 9/27/24
🕰️ 500 pm EST

@JRogersMD1 @JerryEstepMD @Zac0x
@FilioBillia @emanrashed01 @noshreza

[Zachary Cox @Zac0x]

@DmitryAbramovMD @FH_Verbrugge @kevin_damman Not to my knowledge. Would love to learn of one if someone knows.

[Mark Kittipibul MD @vkittipibul]

Check out our review on "SGLT2i and GU infections" in @JACCJournals

🔗: https://t.co/v5ej67V2Hx

Here we discuss
- SGLT2i mechanisms/benefits
- Trial/real-world evidence of SGLT2i/GU ifx
- Risk factors
- Practice considerations

🧵 to follow (1/5)

[JACC Journals @JACCJournals]

In #DICTATE trial, dapagliflozin was safe to start first day of AHF hospitalization before stabilization to optimize #GDMT & improve some measures of diuresis. #SGLT2i should be started immediately or continued in most pts hospitalized for AHF https://t.co/aSpTc3Pu6G #JACC @Zac0x