Comparative effectiveness of torsemide versus furosemide in heart failure patients: insights from the PROTECT trial. (September 2015)

• Record Type: Journal Article
• Authors: Mentz, Robert J; Velazquez, Eric J; Metra, Marco; McKendry, Colleen; Chiswell, Karen; Fiuzat, Mona; Givertz, Michael M; Voors, Adriaan A; Teerlink, John R; O'Connor, Christopher M
• Is Part Of: Future cardiology. Volume 11:Number 5(2015)
• Page Start: 585
• Page End: 595
• Publication Date: 2015-09
• Subjects: furosemide -- heart failure -- loop diuretics -- outcomes -- torsemide; Cardiology -- Research -- Periodicals; 616.12005
• DOI: 10.2217/fca.15.56
• Languages: English
• ISSNs: 1479-6678

Abstract

Aim: The authors assessed the comparative effectiveness of torsemide versus furosemide in the PROTECT trial.Methods: The authors assessed the relationship between loop diuretic at discharge and death or cardiovascular/renal hospitalization within 30 days, and death through 150 days postdischarge using inverse probability weighting.Results: Out of 1004 patients, 83.5% received furosemide and 16.5% torsemide. Torsemide patients had higher blood urea nitrogen, and more in-hospital worsening heart failure. Following adjustment, torsemide was associated with similar 30-day outcomes compared with furosemide (p = 0.93), but remained associated with increased 150-day death (hazard ratio: 2.26; 95% CI: 1.40–3.66; p < 0.001).Conclusion: Patients treated with torsemide had features of greater disease severity, similar 30-day outcomes but increased 150-day mortality. Prospective randomized trials are needed to investigate the effect of torsemide versus furosemide.