Torsemide vs Furosemide Among Patients With New-Onset vs Worsening Chronic Heart Failure

作者：Selim R. Krim, Senthil Anand, Stephen J. Greene, Anqi Chen, Daniel Wojdyla, Juan Vilaro, Herbert Haught, John M. Herre, Eric L. Eisenstein, Kevin J. Anstrom, Bertram Pitt, Eric J. Velazquez, Robert J. Mentz · 发表于：JAMA Cardiology · 年份：2023 · DOI：10.1001/jamacardio.2023.4776 · 被引用次数：6 · 研究领域：Heart Failure Treatment and Management、Cardiac pacing and defibrillation studies、Diabetes Treatment and Management

Importance: Differences in clinical profiles, outcomes, and diuretic treatment effects may exist between patients with de novo heart failure (HF) and worsening chronic HF (WHF). Objectives: To compare clinical characteristics and treatment outcomes of torsemide vs furosemide in patients hospitalized with de novo HF vs WHF. Design, Setting, and Participants: All patients with a documented ejection fraction who were randomized in the Torsemide Comparison With Furosemide for Management of Heart Failure (TRANSFORM-HF) trial, conducted from June 18 through March 2022, were included in this post hoc analysis. Study data were analyzed March to May 2023. Exposure: Patients were categorized by HF type and further divided by loop diuretic strategy. Main Outcomes and Measures: End points included all-cause mortality and hospitalization outcomes over 12 months, as well as change from baseline in the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS). Results: Among 2858 patients (mean [SD] age, 64.5 [14.0] years; 1803 male [63.1%]), 838 patients (29.3%) had de novo HF, and 2020 patients (70.7%) had WHF. Patients with de novo HF were younger (mean [SD] age, 60.6 [14.5] years vs 66.1 [13.5] years), had a higher glomerular filtration rate (mean [SD], 68.6 [24.9] vs 57.0 [24.0]), lower levels of natriuretic peptides (median [IQR], brain-type natriuretic peptide, 855.0 [423.0-1555.0] pg/mL vs 1022.0 [500.0-1927.0] pg/mL), and tended to be discharged on lower doses of l...