{"id":"e378af941d9c","type":"article","url":"https://hartvaat.nl/2024/02/01/transform-hf-torsemide-versus-furosemide-bij-nieuw-vs-chronisch-hartfalen/","title":"TRANSFORM-HF: torsemide versus furosemide bij nieuw vs chronisch hartfalen","title_en":"Torsemide vs Furosemide Among Patients With New-Onset vs Worsening Chronic Heart Failure: A Substudy of the TRANSFORM-HF Randomized Clinical Trial.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog"],"tags":["diuretica","furosemide","hfmref","hfref"],"journal":"JAMA cardiology","doi":"10.1001/jamacardio.2023.4776","source_url":"https://doi.org/10.1001/jamacardio.2023.4776","authors":["Selim R Krim","Senthil Anand","Stephen J Greene","Anqi Chen","Daniel Wojdyla","Juan Vilaro","Herbert Haught","John M Herre","Eric L Eisenstein","Kevin J Anstrom","Bertram Pitt","Eric J Velazquez","Robert J Mentz"],"significance":6,"published":"2024-02-01","source_date":"2024-02-01","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/lisdiuretica-furosemide-bumetanide/"],"congress":"","summary_en":"This TRANSFORM-HF substudy showed no difference between torsemide and furosemide in either new-onset or worsening chronic heart failure, confirming loop diuretic equivalence across HF presentations.","created":"2026-07-03T10:30:46Z","updated":"2026-07-03T13:29:49Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Subanalyse van TRANSFORM-HF vergeleek torsemide met furosemide bij nieuw versus chronisch hartfalen. Er was geen verschil in uitkomsten in beide subgroepen, wat het ontbreken van voordeel van torsemide over furosemide definitief bevestigt.","abstract_original":"IMPORTANCE: Differences in clinical profiles, outcomes, and diuretic treatment effects may exist between patients with de novo heart failure (HF) and worsening chronic HF (WHF). OBJECTIVES: To compare clinical characteristics and treatment outcomes of torsemide vs furosemide in patients hospitalized with de novo HF vs WHF. DESIGN, SETTING, AND PARTICIPANTS: All patients with a documented ejection fraction who were randomized in the Torsemide Comparison With Furosemide for Management of Heart Failure (TRANSFORM-HF) trial, conducted from June 18 through March 2022, were included in this post hoc analysis. Study data were analyzed March to May 2023. EXPOSURE: Patients were categorized by HF type and further divided by loop diuretic strategy. MAIN OUTCOMES AND MEASURES: End points included all-cause mortality and hospitalization outcomes over 12 months, as well as change from baseline in the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS). RESULTS: Among 2858 patients (mean [SD] age, 64.5 [14.0] years; 1803 male [63.1%]), 838 patients (29.3%) had de novo HF, and 2020 patients (70.7%) had WHF. Patients with de novo HF were younger (mean [SD] age, 60.6 [14.5] years vs 66.1 [13.5] years), had a higher glomerular filtration rate (mean [SD], 68.6 [24.9] vs 57.0 [24.0]), lower levels of natriuretic peptides (median [IQR], brain-type natriuretic peptide, 855.0 [423.0-1555.0] pg/mL vs 1022.0 [500.0-1927.0] pg/mL), and tended to be discharged on lower doses of loop diuretic (mean [SD], 50.3 [46.2] mg vs 63.8 [52.4] mg). De novo HF was associated with lower all-cause mortality at 12 months (de novo, 65 of 838 [9.1%] vs WHF, 408 of 2020 [25.4%]; adjusted hazard ratio [aHR], 0.50; 95% CI, 0.38-0.66; P < .001). Similarly, lower all-cause first rehospitalization at 12 months and greater improvement from baseline in KCCQ-CSS at 12 months were noted among patients with de novo HF (median [IQR]: de novo, 29.94 [27.35-32.54] vs WHF, 23.68 [21.62-25.74]; adjusted estimated difference in means: 6.26; 95% CI, 3.72-8.81; P < .001). There was no significant difference in mortality with torsemide vs furosemide in either de novo (No. of events [rate per 100 patient-years]: torsemide, 27 [7.4%] vs furosemide, 38 [10.9%]; aHR, 0.70; 95% CI, 0.40-1.14; P = .15) or WHF (torsemide 212 [26.8%] vs furosemide, 196 [24.0%]; aHR, 1.08; 95% CI, 0.89-1.32; P = .42; P for interaction = .10), In addition, no significant differences in hospitalizations, first all-cause hospitalization, or total hospitalizations at 12 months were noted with a strategy of torsemide vs furosemide in either de novo HF or WHF. CONCLUSIONS AND RELEVANCE: 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."}