Heart failure & cardiomyopathiesSecondary analysis
Comparative effectiveness of torsemide vs furosemide in the management of heart failure patients: Win-ratio reanalysis of the TRANSFORM-HF trial
- secondary analysis of the pragmatic, multicenter, open-label, randomized TRANSFORM-HF trial
- 60 US hospitals
- win-ratio reanalysis
- inverse probability weighting
Authors' conclusion
The overall WR comparison between torsemide and furosemide showed no statistically significant difference in the primary 12-month analysis. The WR framework provided an interpretive decomposition across outcome domains but did not establish superiority of either loop diuretic strategy. All findings should be considered exploratory.
Study context
- Population
- Patients hospitalized with heart failure (HF)randomized to torsemide or furosemide
- Participants
- 2,859 patients
- Comparison
- a strategy of torsemide vs furosemide
- Primary endpoint
- Hierarchical composite: (1) all-cause mortality, (2) recurrent all-cause hospitalizations, (3) lack of improvement in KCCQ-CSS
- Follow-up
- 12 months
Primary result
As reported in the abstract
Adjusted win-ratio (WR)
1.07
95% CI 0.98–1.16
P = 0.13
Further findings
| Outcome | adjusted WR (95% CI) | P value |
|---|---|---|
| Hierarchical composite with extended mortality follow-up (supplementary) · 30 months | 1.06 (0.98–1.16) | P = 0.14 |
- Hierarchical composite with extended mortality follow-up (supplementary): hospitalization and Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) components were assessed through 12 months
As-treated sensitivity analyses
- Consistent with the neutral primary findings
Exploratory subgroup analyses
- not adjusted for multiplicity and should be considered hypothesis-generating
Original publication
Comparative effectiveness of torsemide vs furosemide in the management of heart failure patients: Win-ratio reanalysis of the TRANSFORM-HF trial. Am Heart J. Published 8 July 2026. doi:10.1016/j.ahj.2026.107525
Summarised from the published abstract; every number is checked against it