Heart failure & cardiomyopathiesSecondary analysis
Torsemide vs Furosemide Among Patients With New-Onset vs Worsening Chronic Heart Failure
- Post hoc analysis of the TRANSFORM-HF randomised trial
Authors' conclusion
Among patients discharged after hospitalization for HF, de novo HF was associated with better clinical and patient-reported outcomes when compared with WHF. Regardless of HF type, there was no significant difference between torsemide and furosemide with respect to 12-month clinical or patient-reported outcomes.
Study context
- Population
- Patients hospitalized with heart failure (HF) with a documented EF, randomized in TRANSFORM-HF
- Participants
- 2,858 patients
- Comparison
- De novo HF vs WHF; torsemide vs furosemide within each HF type
- De novo HFn = 838
- WHFn = 2,020reference
- Primary endpoint
- All-cause mortality, hospitalization outcomes and change from baseline in Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS)
- Follow-up
- 12 months
Primary result
All-cause mortality
Adjusted hazard ratio
0.50
95% CI 0.38–0.66
P < 0.001
Events by treatment group
De novo HF vs WHF
aHR 0.50 (95% CI 0.38–0.66); P < 0.001
As reported in the abstract
Further findings
Median
| Outcome | De novo HF | WHF | Torsemide | Furosemide | adjusted estimated difference in means (95% CI) | P value | |
|---|---|---|---|---|---|---|---|
| Change from baseline in KCCQ-CSS · 12 months | 29.94 (IQR 27.35–32.54) | 23.68 (IQR 21.62–25.74) | Not reported in the abstract | Not reported in the abstract | 6.26 (3.72–8.81) | P < 0.001 | |
| −50510Difference (linear scale) |
| Outcome | De novo HF | WHF | Torsemide | Furosemide | aHR (95% CI) | P value | |
|---|---|---|---|---|---|---|---|
| Mortality, torsemide vs furosemide, de novo HF (subgroup) | Not reported in the abstract | Not reported in the abstract | 7.4% | 10.9% | 0.70 (0.40–1.14) | P = 0.15 | |
| Mortality, torsemide vs furosemide, WHF (subgroup) | Not reported in the abstract | Not reported in the abstract | 26.8% | 24.0% | 1.08 (0.89–1.32) | P = 0.42 | |
| 0.512Adjusted hazard ratio (log scale) |
- Mortality, torsemide vs furosemide, WHF (subgroup): P for interaction = .10
All-cause first rehospitalization · 12 months
- Lower with de novo HF than WHF
Hospitalizations, torsemide vs furosemide · 12 months
- No significant differences in de novo HF or WHF
Original publication
Torsemide vs Furosemide Among Patients With New-Onset vs Worsening Chronic Heart Failure. JAMA Cardiol. Published 1 February 2024. doi:10.1001/jamacardio.2023.4776
Summarised from the published abstract; every number is checked against it