{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T19:19:45Z","timestamp":1769109585071,"version":"3.49.0"},"reference-count":8,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:sec id=\"ab-hbr230024-4\"><jats:title>Importance<\/jats:title><jats:p>Differences in clinical profiles, outcomes, and diuretic treatment effects may exist between patients with de novo heart failure (HF) and worsening chronic HF (WHF).<\/jats:p><\/jats:sec><jats:sec id=\"ab-hbr230024-5\"><jats:title>Objectives<\/jats:title><jats:p>To compare clinical characteristics and treatment outcomes of torsemide vs furosemide in patients hospitalized with de novo HF vs WHF.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hbr230024-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hbr230024-7\"><jats:title>Exposure<\/jats:title><jats:p>Patients were categorized by HF type and further divided by loop diuretic strategy.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hbr230024-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>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).<\/jats:p><\/jats:sec><jats:sec id=\"ab-hbr230024-9\"><jats:title>Results<\/jats:title><jats:p>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; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). 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; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). 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; <jats:italic>P<\/jats:italic>\u2009=\u2009.15) or WHF (torsemide 212 [26.8%] vs furosemide, 196 [24.0%]; aHR, 1.08; 95% CI, 0.89-1.32; <jats:italic>P<\/jats:italic>\u2009=\u2009.42; <jats:italic>P<\/jats:italic> 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.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hbr230024-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamacardio.2023.4776","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T16:00:52Z","timestamp":1699891252000},"page":"182","source":"Crossref","is-referenced-by-count":5,"title":["Torsemide vs Furosemide Among Patients With New-Onset vs Worsening Chronic Heart Failure"],"prefix":"10.1001","volume":"9","author":[{"given":"Selim R.","family":"Krim","sequence":"first","affiliation":[{"name":"Section of Cardiomyopathy & Heart Transplantation, John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana"},{"name":"The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Senthil","family":"Anand","sequence":"additional","affiliation":[{"name":"Section of Cardiomyopathy & Heart Transplantation, John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen J.","family":"Greene","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, North Carolina"},{"name":"Department of Medicine, Division of Cardiology, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anqi","family":"Chen","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Wojdyla","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Vilaro","sequence":"additional","affiliation":[{"name":"University of Florida, Gainsville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert","family":"Haught","sequence":"additional","affiliation":[{"name":"Huntsville Hospital, Huntsville, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Herre","sequence":"additional","affiliation":[{"name":"Sentara Norfolk General Hospital, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric L.","family":"Eisenstein","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin J.","family":"Anstrom","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Velazquez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Mentz","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, North Carolina"},{"name":"Department of Medicine, Division of Cardiology, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","reference":[{"issue":"2","key":"hbr230024r1","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.tcm.2019.03.007","article-title":"Acute heart failure.","volume":"30","author":"Sinnenberg","year":"2020","journal-title":"Trends Cardiovasc Med"},{"issue":"30","key":"hbr230024r2","doi-asserted-by":"publisher","first-page":"1958","DOI":"10.1093\/eurheartj\/ehv066","article-title":"Recommendations on pre-hospital and early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine\u2013short version.","volume":"36","author":"Mebazaa","year":"2015","journal-title":"Eur Heart J"},{"issue":"5","key":"hbr230024r3","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1016\/j.jchf.2021.01.013","article-title":"Pragmatic design of 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Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamacardiology\/articlepdf\/2811982\/jamacardiology_krim_2023_br_230024_1706752526.04153.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T16:02:38Z","timestamp":1707926558000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamacardiology\/fullarticle\/2811982"}},"subtitle":["A Substudy of the TRANSFORM-HF Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2024,2,1]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamacardio.2023.4776","relation":{},"ISSN":["2380-6583"],"issn-type":[{"value":"2380-6583","type":"print"}],"subject":[],"published":{"date-parts":[[2024,2,1]]}}}