Miejsce diuretyków pętlowych w leczeniu ostrej niewydolności serca

Loop diuretics are used as first-line medications in patients with heart failure as they result in symptomatic improvement related to relieving organ congestion. The recommendations regarding the use of loop diuretics are mostly based on expert opinion, without preference of specific drugs. Thus, the choice of optimal diuretic treatment strategy in acute heart failure requires knowledge about differences in the characteristics of loop diuretics available in Poland, furosemide and torasemide. Non-renal pleiotropic effects of torasemide should be also borne in mind. Clinically significant differences in the pharmacokinetics and biological effects of furosemide and torasemide have been reflected in multiple research studies and meta-analyses published in the recent several years. These studies provided consistent evidence for the good safety profile of torasemide, and its superior efficacy in regard to the improvement of exercise tolerance and reduced readmissions due to heart failure compared to furosemide. The effect of torasemide on mortality reduction in patients with heart failure, seen in some studies, requires further evaluation.