{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:33:51Z","timestamp":1772253231569,"version":"3.50.1"},"reference-count":33,"publisher":"Sociedade Brasileira de Cardiologia","issue":"6","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo A furosemida \u00e9 o diur\u00e9tico mais utilizado para o tratamento de sintomas de sobrecarga de volume em pacientes com insufici\u00eancia card\u00edaca. Dados recentes sugerem que a torsemida pode ser superior \u00e0 furosemida neste contexto. No entanto, ainda n\u00e3o \u00e9 claro se isso se traduz em melhores resultados cl\u00ednicos nesta popula\u00e7\u00e3o. Avaliar se a torsemida \u00e9 superior \u00e0 furosemida no contexto da insufici\u00eancia card\u00edaca. Realizamos uma revis\u00e3o sistem\u00e1tica e metan\u00e1lise de estudos cl\u00ednicos randomizados (ECRs) comparando a efic\u00e1cia da torsemida em compara\u00e7\u00e3o com a furosemida em pacientes com insufici\u00eancia card\u00edaca. PubMed, Embase e Web of Science foram as bases de dados pesquisadas em busca de estudos eleg\u00edveis. Os desfechos de interesse foram interna\u00e7\u00f5es por todas as causas, interna\u00e7\u00f5es por insufici\u00eancia card\u00edaca (IIC), interna\u00e7\u00f5es por todas as causas cardiovasculares, mortalidade por todas as causas, e melhoria de classe da NYHA. Par\u00e2metros ecocardiogr\u00e1ficos tamb\u00e9m foram avaliados. Foi aplicado um modelo de efeitos aleat\u00f3rios para calcular as raz\u00f5es de risco (RR) e as diferen\u00e7as m\u00e9dias (DM) com intervalos de confian\u00e7a (IC) de 95% e n\u00edvel de signific\u00e2ncia de 0,05. Foram inclu\u00eddos 12 ECRs, envolvendo 4.115 pacientes. A torsemida reduziu significativamente a IIC (RR de 0,60; IC de 95%, 0,43-0,83; p=0,002; I2=0%), interna\u00e7\u00e3o por causas cardiovasculares (RR de 0,72; IC de 95%, 0,60-0,88; p=0,0009; I2=0%), e melhora da fra\u00e7\u00e3o de eje\u00e7\u00e3o do ventr\u00edculo esquerdo (FEVE) (DM de 4,51%; IC de 95%, 2,94 a 6,07; p&lt;0,0001; I2=0%) em compara\u00e7\u00e3o com a furosemida. N\u00e3o houve diferen\u00e7a significativa no n\u00famero de interna\u00e7\u00f5es por todas as causas (RR de 0,93; IC de 95%, 0,86-1,00; p=0,04; I2=0%), mortalidade por todas as causas (RR de 0,98; IC de 95%, 0,87-1,10; p=0,73; I2=0%), melhora da classe NYHA (RR de 1,25; IC de 95%, 0,92-1,68; p=0,15; I2=0%), ou mudan\u00e7a de classe NYHA (DM de -0,04; IC de 95%, -0,24 a 0,16; p=0,70; I2=15%) entre os grupos. A torsemida reduziu significativamente as interna\u00e7\u00f5es por insufici\u00eancia card\u00edaca e causas cardiovasculares, melhorando tamb\u00e9m a FEVE.<\/jats:p>","DOI":"10.36660\/abc.20230825","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T15:53:22Z","timestamp":1721922802000},"source":"Crossref","is-referenced-by-count":4,"title":["Torsemida em Compara\u00e7\u00e3o com Furosemida no Tratamento da Insufici\u00eancia Card\u00edaca: Uma Revis\u00e3o Sistem\u00e1tica e Metan\u00e1lise de Ensaios Cl\u00ednicos Randomizados"],"prefix":"10.36660","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7714-7148","authenticated-orcid":false,"given":"Larissa","family":"Teixeira","sequence":"first","affiliation":[{"name":"Universidade Federal de Campina Grande,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8174-3866","authenticated-orcid":false,"given":"Nicole","family":"Felix","sequence":"additional","affiliation":[{"name":"Universidade Federal de Campina Grande,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4805-0931","authenticated-orcid":false,"given":"Denilsa D. P.","family":"Navalha","sequence":"additional","affiliation":[{"name":"Universidade Eduardo Mondlane,  Mo\u00e7ambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3203-0509","authenticated-orcid":false,"given":"Rafael","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Universidade Federal de Santa Catarina,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana R.C.","family":"Clemente","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de Petr\u00f3polis,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9497-3039","authenticated-orcid":false,"given":"Thiago","family":"Madeira","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  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