Comparative effects of intravenous furosemide and torsemide on survival and length of hospital stay in acute heart failure.

OBJECTIVE: Aim: To investigate the impact of the initial choice between intravenous furosemide and torsemide on mortality outcomes and duration of hospital stay. PATIENTS AND METHODS: Materials and Methods: The prospective, open-label, comparative study included 68 adult patients hospitalized with acute heart failure (AHF). Furosemide was administered to 35 patients (51.5%) and torsemide to 33 patients (48.5%) during the first 48 hours after admission. Diuretic dosing was titrated according to urinary sodium concentration. After the initial 48 hours, further diuretic therapy was administered at the discretion of the attending physician. The primary endpoint was all-cause mortality, and the secondary endpoints were length of hospital stay and in-hospital mortality. RESULTS: Results: All-cause mortality was 51.4% in patients treated with furosemide and 42.4% in those treated with torsemide (p=0.478). The median survival time was 633 days (95% CI 178-1,259) in the furosemide group and 1,093 days (95% CI 541-1,239) in the torsemide group, with no statistically significant difference in survival between the two treatment groups (p=0.44). No in-hospital deaths occurred in the torsemide group, whereas four in-hospital deaths (11.4%) were observed in the furosemide group (p=0.115). The mean length of hospital stay was 12±7 days in both groups (p=0.551). CONCLUSION: Conclusions: Both furosemide and torsemide showed no statistically significant differences in all-cause mortality, in-hospital mortality, and length of hospital stay.