No benefit with torsemide over furosemide for posthospitalization treatment of heart failure (TRANSFORM-HF)

Clinical Question

For patients discharged after hospitalization for acute heart failure, does long-term torsemide decrease all-cause mortality more than furosemide?

Bottom line

In this pragmatic trial, there was no difference in all-cause mortality when comparing torsemide with furosemide in patients following hospitalization for acute heart failure. However, interpretation of the study results is limited because of loss to follow-up, crossover of trial participants, and nonadherence to study drugs. Furthermore, new changes in guideline-directed medical therapy for heart failure — specifically, the addition of angiotensin receptor–neprilysin inhibitors and sodium-glucose cotransporter-2 inhibitors — may have affected outcomes as well as diuretic requirements over the course of the trial. 1b-

Study design: Randomized controlled trial (nonblinded)

Funding: Government

Setting: Inpatient (any location) with outpatient follow-up


Nita Shrikant Kulkarni, MD
Assistant Professor in Hospital Medicine
Northwestern University
Chicago, IL

Discuss this POEM



No advantage of newer more expensive options to Lassie

Good to know

Arup Kumar Dhara

Impact assessment

Very good