• Nourin Ali Sherif, Mostafa Ebraheem Morra, Le Van Thanh, Ghadeer Gamal Elsayed, Aya Hesham Elkady, Abdelrahman Elshafay, Nguyen Dang Kien, Ahmed Al-Habbaa, Le Huu Nhat Minh, Mai Nhu Y, Thai Le Ba Nghia, Abdelrhman Tarek Mohammed, Peter Samuel Eid, Tarek Turk, Kenji Hirayama, and Nguyen Tien Huy.
• Faculty of Medicine, Mansoura University, Mansoura, Egypt.
• J Eval Clin Pract. 2020 Jun 1; 26 (3): 842-851.

AimDiuretics are a cornerstone in treatment of heart failure (HF). Torasemide is a loop diuretic with a potential advantage over other diuretics. We aim to meta-analyse and compare the effect of torasemide with furosemide in HF patients.MethodsA comprehensive literature search using 12 databases including PubMed, Scopus, and Web of Science was performed. All randomized controlled trials (RCTs) comparing furosemide and torasemide in HF patients were included and meta-analysed. We assessed the risk of bias using Cochrane Collaboration's tool. The protocol was registered in PROSPERO (CRD42016046112).ResultsEighteen RCTs with 1598 patients were included. There was a significant difference between torasemide 20 mg and furosemide 40 mg in increasing the urine volume (standard difference of the mean (SDM) [95% confidence interval] = -0.78 [-1.52 to -0.053], P = .036). Torasemide 10 mg and 10 to 20 mg have a significant effect on potassium excretion in comparison with furosemide 25 to 40 mg (P = .018 and .023, respectively). In general, torasemide and furosemide have no significant difference in mortality, edema improvement, weight loss, heart rate, and reducing systolic/diastolic blood pressure. However, oral torasemide has a significant lower hospital stay P < .001 and superior effect in improving ejection fraction P = .029.ConclusionAlthough not all results are statistically significant, torasemide has potential advantages on multiple aspects of HF management when compared with furosemide. More studies are needed to clarify these effects.© 2019 John Wiley & Sons, Ltd.

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