Evaluation of Patients with Heart Failure with Reduced Ejection Fraction Treated with Bumetanide versus Torsemide.

IF 1.9 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiology Pub Date : 2025-04-14 DOI:10.1159/000545876
Kazuhiko Kido, Mohammad Al-Mamun
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引用次数: 0

Abstract

Introduction Limited evidence guides clinicians regarding the agent selection between bumetanide and torsemide in patients with heart failure (HF). The present study aimed to compare the efficacy and safety profile of bumetanide and torsemide in patients with HF. Methods Patients aged > 18 years with HF with reduced ejection fraction (HFrEF) receiving either bumetanide or torsemide were included from the TriNetX research network. Patients with end-stage renal disease were excluded from this study. The primary outcome was all-cause mortality, and secondary outcomes included all-cause hospitalization or emergency department visits, acute kidney injury, or hypokalemia over one- year follow-up period. Results After propensity score matching, 16,277 patients in each group were included. The use of bumetanide was significantly associated with a higher risk of all-cause mortality (19.7 vs. 16.0 %; OR 1.28; 95% CI [1,21, 1.36]) compared to the torsemide group. The use of bumetanide was also significantly associated with higher risks of all-cause hospitalization or emergency department visits (53.3 vs. 48.3%; OR 1.22 95% CI [1.17, 1.28]), acute kidney injury (33.4 vs. 27.1 %; OR 1.35; 95% CI [1.29, 1.42]), and hypokalemia (16.6 vs. 13.7%; OR 1.21, 95% CI [1.17, 1.33]) compared to the torsemide group. Conclusion The use of torsemide in patients with HFrEF is associated with lower risks of clinical outcomes than bumetanide. Further investigation of this association is warranted in clinical trials.

布美他尼与托尔塞米治疗心力衰竭伴射血分数降低患者的评价。
有限的证据指导临床医生在布美他尼和托尔塞米之间的药物选择心力衰竭(HF)患者。本研究旨在比较布美他尼和托塞米在心衰患者中的疗效和安全性。方法从TriNetX研究网络中纳入年龄在bb0 ~ 18岁的HF伴射血分数降低(HFrEF)患者,接受布美他尼或托尔塞米治疗。终末期肾病患者被排除在本研究之外。主要结局是全因死亡率,次要结局包括全因住院或急诊就诊、急性肾损伤或一年随访期间的低钾血症。结果经倾向评分匹配后,两组共纳入16277例患者。布美他尼的使用与更高的全因死亡率风险显著相关(19.7%对16.0%;或1.28;95% CI[1,21,1.36])与torsemide组比较。布美他尼的使用也与全因住院或急诊就诊的高风险显著相关(53.3 vs 48.3%;OR 1.22 95% CI[1.17, 1.28]),急性肾损伤(33.4%∶27.1%;或1.35;95% CI[1.29, 1.42])和低钾血症(16.6% vs. 13.7%;OR为1.21,95% CI[1.17, 1.33])。结论在HFrEF患者中使用托尔塞米的临床结局风险低于布美他尼。在临床试验中进一步调查这种关联是有必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cardiology
Cardiology 医学-心血管系统
CiteScore
3.40
自引率
5.30%
发文量
56
审稿时长
1.5 months
期刊介绍: ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.
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