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The Effect of Diuretics on Patients with Heart Failure: A Network Meta-Analysis: Diuretics Effect on Heart Failure

Xingsheng Zhao1, Yu Ren, Hui Li

  • 1Cardiology Department, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia Autonomous Region, China.

Journal of Pharmacy & Pharmaceutical Sciences : a Publication of the Canadian Society for Pharmaceutical Sciences, Societe Canadienne Des Sciences Pharmaceutiques
|July 10, 2019
PubMed

Insights

Torasemide may be the optimal treatment for heart failure (HF) patients, showing better effects on mortality, brain natriuretic peptide (BNP), and left ventricular ejection fraction (LVEF) compared to other diuretics.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Research

Background:

  • Heart failure (HF) is a complex clinical syndrome requiring effective pharmacological management.
  • Diuretics such as torasemide, tolvaptan, furosemide, and azosemide are commonly used in HF treatment.
  • Comparative effectiveness data for these diuretics in HF patients is crucial for optimizing therapeutic strategies.

Purpose of the Study:

  • To comprehensively evaluate and compare the curative effects of torasemide, tolvaptan, furosemide, and azosemide in patients with heart failure.
  • To determine the optimal diuretic treatment for heart failure based on efficacy and safety profiles.

Main Methods:

  • A systematic literature search was conducted until May 2018 to identify relevant studies.
  • A network meta-analysis was performed to pool data from 12 selected studies.
  • Quality assessment, data extraction, and heterogeneity analysis (I2 statistic and Q-test) were performed.

Main Results:

  • Direct meta-analysis showed significant differences in left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP) between furosemide and azosemide, and in adverse effects between furosemide and torasemide.
  • Network meta-analysis indicated no significant differences in adverse effects, mortality, BNP, or LVEF among the studied diuretics.
  • Torasemide was associated with relatively lower mortality and slight improvements in BNP and LVEF.

Conclusions:

  • Torasemide demonstrates a potentially optimal comprehensive curative effect for heart failure patients.
  • Further research may be warranted to confirm the superiority of torasemide in specific HF subpopulations.
Abstract

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