Heart failure & cardiomyopathiesSecondary analysis
Diuretic resistance risk and the efficacy of torsemide vs furosemide: a post-hoc analysis of the TRANSFORM-HF trial
- Secondary analysis of the TRANSFORM-HF randomised trial
- post-hoc analysis
Authors' conclusion
Among patients discharged after HF hospitalization, higher diuretic resistance risk, assessed by the BAN-ADHF score, is associated with higher risk of mortality, HF hospitalization, and worse quality-of-life. Diuretic resistance risk status did not modify the treatment effects of torsemide versus furosemide.
Study context
- Population
- Patients randomised to torsemide or furosemide in TRANSFORM-HF who survived to discharge after HF hospitalization, with available BAN-ADHF scores
- Participants
- 2,421 patients
- Comparison
- High vs low diuretic resistance risk (BAN-ADHF score ≥12); effect modification of torsemide vs furosemide
- High diuretic resistance riskn = 512
- Primary endpoint
- All-cause mortality, all-cause hospitalization and quality of life (KCCQ-CSS)
- Follow-up
- 12 months
Primary result
As reported in the abstract
High diuretic resistance risk vs Low diuretic resistance riskaHRP value
all-cause mortality
1.79(95% CI 1.45–2.21)
P < 0.001all-cause hospitalization
1.34(CI 1.15–1.55)
P < 0.001- 12-month KCCQ-CSS improvement, lower
- difference −3.4 points; P = 0.037
Further findings
Effect modification of torsemide vs furosemide by diuretic resistance risk
- No modification of treatment effect on all-cause mortality
- P for interaction = 0.54
- No modification of treatment effect on all-cause hospitalization
- P for interaction = 0.74
- No modification of treatment effect on quality of life at follow-up
- P for interaction > 0.05 at each timepoint
Original publication
Diuretic resistance risk and the efficacy of torsemide vs furosemide: a post-hoc analysis of the TRANSFORM-HF trial. Eur J Heart Fail. Published 25 June 2026. doi:10.1093/ejhf/xuag207
Summarised from the published abstract; every number is checked against it