Loop diuretics: old and new ones — which one to choose in clinical practice? Experts’ Group Consensus endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy and Working Group on Heart Failure

Mamcarz, Artur; Filipiak‬, Krzysztof J.; Dróżdż, Jarosław; Nessler, Jadwiga; Tykarski, Andrzej; Niemczyk, Mariusz; Wożakowska−Kapłon, Beata

doi:10.5603/kp.2015.0051

Cited by 6 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…So far, two expert groups, drawing on the available clinical reports and economic advantages, recommended consideration of torasemide use over furosemide in HF patients [31,32]. It seems that our study supports previous reports demonstrating that treatment with torasemide might translate into improvement of NYHA functional class, quality of life and better prognosis of patients with HF, compared to furosemide, but it is just an observational study.…”

Section: Discussionsupporting

confidence: 79%

Comparative Analysis of Long-Term Outcomes of Torasemide and Furosemide in Heart Failure Patients in Heart Failure Registries of the European Society of Cardiology

Ozierański

Balsam

Kapłon‐Cieślicka

et al. 2019

Cardiovasc Drugs Ther

Self Cite

View full text Add to dashboard Cite

Purpose. Current clinical recommendations do not emphasise superiority of any of diuretics, but available reports are very encouraging and suggest beneficial effects of torasemide. This study aimed to compare the effect of torasemide and furosemide on long-term outcomes and New York Heart Association (NYHA) class change in patients with chronic heart failure (HF). Methods. Of 2019 patients enrolled in Polish parts of the heart failure registries of the European Society of Cardiology (Pilot and Long-Term), 1440 patients treated with a loop diuretic were included in the analysis. The main analysis was performed on matched cohorts of HF patients treated with furosemide and torasemide using propensity score matching. Results. Torasemide was associated with a similar primary endpoint (all-cause death; 9.8% vs. 14.1%; p = 0.13) occurrence and 23.8% risk reduction of the secondary endpoint (a composite of all-cause death or hospitalisation for worsening HF; 26.4% vs. 34.7%; p = 0.04). Treatment with both torasemide and furosemide was associated with the significantly most frequent occurrence of the primary (23.8%) and secondary (59.2%) endpoints. In the matched cohort after 12 months, NYHA class was higher in the furosemide group (p = 0.04), while furosemide use was associated with a higher risk (20.0% vs. 12.9%; p = 0.03) of worsening ≥ 1 NYHA class. Torasemide use impacted positively upon the primary endpoint occurrence, especially in younger patients (aged < 65 years) and with dilated cardiomyopathy. Conclusions. Our findings contribute to the body of research on the optimal diuretic choice. Torasemide may have advantageous influence on NYHA class and long-term outcomes of HF patients, especially younger patients or those with dilated cardiomyopathy, but it needs further investigations in prospective randomised trials.

show abstract

Section: Discussionsupporting

confidence: 79%

Comparative Analysis of Long-Term Outcomes of Torasemide and Furosemide in Heart Failure Patients in Heart Failure Registries of the European Society of Cardiology

Ozierański

Balsam

Kapłon‐Cieślicka

et al. 2019

Cardiovasc Drugs Ther

Self Cite

View full text Add to dashboard Cite

show abstract

“…Furthermore, there are many implications of wider possibilities of using new, modern drugs within the individual therapeutic groups, which mode of action does not confirm the "class effect". In this context, the following molecules might be particularly preferable as SPC combinations in the future: -Eplerenone, and in the future finerenone over spironolactone [66]; -Torasemide over furosemide [67]; -Ranolazine over trimetazidine [68]; -Nebivolol over older beta-blockers [69].…”

Section: Times To Actmentioning

confidence: 99%

TIMES TO ACT. Italian-Spanish-Polish-Uzbek Expert Forum Position Paper 2022. Dyslipidemia and arterial hypertension: The two most important and modifiable risk factors in clinical practice

Filipiak‬¹,

Babkowski

Cameli

et al. 2022

Cardiol J.

View full text Add to dashboard Cite

Hypertension and lipid disorders are two of the main cardiovascular risk factors. Both risk factors -if detected early enough -can be controlled and treated with modern, effective drugs, devoid of significant side effects, available in four countries as different as Italy, Spain, Poland, and Uzbekistan. The aim herein, was to develop this TIMES TO ACT consensus to raise the awareness of the available options of the modern and intensified dyslipidemia and arterial hypertension treatments. The subsequent paragraphs involves consensus and discussion of the deleterious effects of COVID-19 in the cardiovascular field, the high prevalence of hypertension and lipid disorders in our countries and the most important reasons for poor control of these two factors. Subsequently proposed, are currently the most efficient and safe therapeutic options in treating dyslipidemia and arterial hypertension, focusing on the benefits of single-pill combination (SPCs) in both conditions. An accelerated algorithm is proposed to start the treatment with a PCSK9 inhibitor, if the target low-density-lipoprotein values have not been reached. As most patients with hypertension and lipid disorders present with multiple comorbidities, discussed are the possibilities of using new SPCs, combining modern drugs from different therapeutic groups, which mode of action does not confirm the "class effect". We believe our consensus strongly advocates the need to search for patients with cardiovascular risk factors and intensify their lipid-lowering and antihypertensive treatment based on SPCs will improve the control of these two basic cardiovascular risk factors in Italy, Spain, Poland and Uzbekistan.

show abstract

“…Torasemide also has anti-aldosterone activity and inhibits myocardial fibrosis and remodeling [4][5][6][7][8]. According to previous studies, torasemide decreases rates of HF hospitalizations and hospital stay, improves exercise tolerance, quality of life, left ventricular function, cardiac sympathetic nerve activity, myocardial fibrosis, pulmonary congestion, peripheral edema, and blood pressure compared with furosemide [9][10][11][12]. These favorable effects of torasemide suggest that this agent would be more beneficial than furosemide in patients with HF.…”

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of torasemide versus furosemide in symptomatic therapy in heart failure patients: Preliminary results from the randomized TORNADO trial

Balsam¹,

Ozierański²,

Marchel³

et al. 2020

Cardiol J.

View full text Add to dashboard Cite

Background: Recent reports suggest that torasemide might be more beneficial than furosemide in patients with symptomatic heart failure (HF). The aim was to compare the effects of torasemide and furosemide on clinical outcomes in HF patients. Methods: This study pilot consisted of data from the ongoing multicenter, randomized, unblinded endpoint phase IV TORNADO (NCT01942109) study. HF patients in New York Heart Association (NYHA) II-IV class with a stable dose of furosemide were randomized to treatment with equipotential dose of torasemide (4:1) or continuation of unchanged dose of furosemide. On enrollment and control visit (3 months after enrollment) clinical examination, 6-minute walk test (6MWT) and assessment of fluid retention by ZOE Fluid Status Monitor were performed. The primary endpoint was a composite of improvement of NYHA class, improvement of at least 50 m during 6MWT and decrease in fluid retention of at least 0.5 W after 3-months follow-up. Results: The study group included 40 patients (median age 66 years; 77.5% male). During follow-up 7 patients were hospitalized for HF worsening (3 in torasemide and 4 in furosemide-treated patients). The primary endpoint reached 15 (94%) and 14 (58%) patients on torasemide and furosemide, respectively (p = 0.03). Conclusions: In HF patients treated with torasemide fluid overload and symptoms improved more than in the furosemide group. This positive effect occurred already within 3-month observation. (Cardiol J 2019; 26, 6: 661-668)

show abstract

Loop diuretics: old and new ones — which one to choose in clinical practice? Experts’ Group Consensus endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy and Working Group on Heart Failure

Cited by 6 publications

References 17 publications

Comparative Analysis of Long-Term Outcomes of Torasemide and Furosemide in Heart Failure Patients in Heart Failure Registries of the European Society of Cardiology

Comparative Analysis of Long-Term Outcomes of Torasemide and Furosemide in Heart Failure Patients in Heart Failure Registries of the European Society of Cardiology

TIMES TO ACT. Italian-Spanish-Polish-Uzbek Expert Forum Position Paper 2022. Dyslipidemia and arterial hypertension: The two most important and modifiable risk factors in clinical practice

Comparative effectiveness of torasemide versus furosemide in symptomatic therapy in heart failure patients: Preliminary results from the randomized TORNADO trial

Contact Info

Product

Resources

About