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射血分数保留的心力衰竭(HFpEF)患者出院后托拉塞米与呋塞米疗效的真实世界经验。

Real world experience in effect of torsemide vs. furosemide after discharge in patients with HFpEF.

作者信息

Li Xiao, Si Jinping, Liu Ying, Xu Danyan

机构信息

Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, China.

Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.

出版信息

ESC Heart Fail. 2025 Feb;12(1):71-79. doi: 10.1002/ehf2.15071. Epub 2024 Sep 5.

Abstract

AIMS

Few studies have focused on the effect of torsemide versus furosemide after discharge on prognosis in patients with heart failure with preserved ejection fraction (HFpEF). This single-centre retrospective real-world study was conducted to evaluate the effect of torsemide versus furosemide after discharge on all-cause mortality and rehospitalization for heart failure in patients with HFpEF.

METHODS

Consecutive patients who were diagnosis with HFpEF after discharge between January 2015 and April 2018 at the First Affiliated Hospital of Dalian Medical University and who had been treated with torsemide or furosemide were included in this study. The primary outcome was all-cause mortality. The second outcome was rehospitalization for heart failure.

RESULTS

A total of 445 patients (mean age 68.56 ± 8.07, female 55%) were divided into the torsemide group (N = 258) or furosemide group (N = 187) based on the treatment course at discharge from the hospital. During a mean follow-up of 87.67 ± 11.15 months, death occurred in 68 of 258 patients (26.36%) in the torsemide group and 60 of 187 patients (30.09%) in the furosemide group [hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.57-1.15, P = 0.239]. Rehospitalization for heart failure occurred in 111 of 258 patients (43.02%) in the torsemide groups and 110 of 187 patients (58.82%) in the furosemide group (HR 0.64, 95% CI 0.49-0.85, P = 0.002).

CONCLUSIONS

Compared with furosemide, torsemide did not significantly reduce all-cause mortality, but there was association between torsemide and reduced rehospitalization for heart failure in patients with HFpEF.

摘要

目的

很少有研究关注托拉塞米与呋塞米在射血分数保留的心力衰竭(HFpEF)患者出院后对预后的影响。本单中心回顾性真实世界研究旨在评估HFpEF患者出院后使用托拉塞米与呋塞米对全因死亡率和心力衰竭再住院率的影响。

方法

纳入2015年1月至2018年4月在大连医科大学附属第一医院出院后诊断为HFpEF且接受过托拉塞米或呋塞米治疗的连续患者。主要结局是全因死亡率。次要结局是心力衰竭再住院率。

结果

根据出院时的治疗疗程,共445例患者(平均年龄68.56±8.07岁,女性占55%)被分为托拉塞米组(N = 258)或呋塞米组(N = 187)。在平均87.67±11.15个月的随访期间,托拉塞米组258例患者中有68例(26.36%)死亡,呋塞米组187例患者中有60例(30.09%)死亡[风险比(HR)0.81,95%置信区间(CI)0.57 - 1.15,P = 0.239]。托拉塞米组258例患者中有111例(43.02%)因心力衰竭再住院,呋塞米组187例患者中有110例(58.82%)因心力衰竭再住院(HR 0.64,95% CI 0.49 - 0.85,P = 0.002)。

结论

与呋塞米相比,托拉塞米并未显著降低全因死亡率,但托拉塞米与HFpEF患者心力衰竭再住院率降低之间存在关联。

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