Robert J Mentz1,2, Eric J Velazquez1,2, Marco Metra3, Colleen McKendry2, Karen Chiswell2, Mona Fiuzat1,2, Michael M Givertz4, Adriaan A Voors5, John R Teerlink6, Christopher M O'Connor1,2. 1. Duke University, Durham, NC 27708, USA. 2. Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA. 3. University of Brescia, Piazza del Mercato, 15, Brescia BS, Italy. 4. Brigham & Women's Hospital, 75 Francis St, Boston, MA 02115, USA. 5. University of Groningen, 9712 CP Groningen, The Netherlands. 6. University of California at San Francisco (SF) & SF Veterans Affairs Medical Center, 500 Parnassus Ave, San Francisco, CA 94143, USA.
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.
RCT Entities:
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. Torsemidepatients had higher blood ureanitrogen, 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.
Authors: Christopher M O'Connor; Robert J Mentz; Gad Cotter; Marco Metra; John G Cleland; Beth A Davison; Michael M Givertz; George A Mansoor; Piotr Ponikowski; John R Teerlink; Adriaan A Voors; Mona Fiuzat; Daniel Wojdyla; Karen Chiswell; Barry M Massie Journal: Eur J Heart Fail Date: 2012-04-25 Impact factor: 15.534
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