25 0 0 0 OA Superiority of Long-Acting to Short-Acting Loop Diuretics in the Treatment of Congestive Heart Failure
- 著者
- Tohru Masuyama Takeshi Tsujino Hideki Origasa Kazuhiro Yamamoto Takashi Akasaka Yutaka Hirano Nobuyuki Ohte Takashi Daimon Satoshi Nakatani Hiroshi Ito
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.76, no.4, pp.833-842, 2012 (Released:2012-03-23)
- 参考文献数
- 30
- 被引用文献数
- 46 49
Background: Diuretics are the most prescribed drug in heart failure (HF) patients. However, clinical evidence about their long-term effects is lacking. The purpose of this study was to compare the therapeutic effects of furosemide and azosemide, a short- and long-acting loop diuretic, respectively, in patients with chronic heart failure (CHF). Methods and Results: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared the effects of azosemide and furosemide in patients with CHF and New York Heart Association class II or III symptoms. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The primary endpoint was a composite of cardiovascular death or unplanned admission to hospital for congestive HF. During a median follow-up of 35.2 months, the primary endpoint occurred in 23 patients in the azosemide group and in 34 patients in the furosemide group (hazard ratio [HR], 0.55, 95% confidence interval [CI] 0.32-0.95: P=0.03). Among the secondary endpoints, unplanned admission to hospital for congestive HF or a need for modification of the treatment for HF were also reduced in the azosemide group compared with the furosemide group (HR, 0.60, 95%CI 0.36-0.99: P=0.048). Conclusions: Azosemide, compared with furosemide, reduced the risk of cardiovascular death or unplanned admission to hospital for congestive HF. (Circ J 2012; 76: 833-842)
言及状況
外部データベース (DOI)
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\\ループ利尿薬の換算//
フロセミド40mg
≒アゾセミド60mg
≒トラセミド8mg
✅短時間から長時間作用へ変更したい時
フロセミド➜アゾセミド
フロセミド➜トラセミド(K変動に注意)
✅ループ利尿使いつつ低Kを避けたい時
フロセミド➜トラセミド
アゾセミド➜トラセミド
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The J-MELODIC Studyは、駆け出しの頃、全文読んで、学会会場でも色々聞きましたが、ツッコミどころが多く、「個人的に」腑に落ちない試験でした。どっちでも良いと思っています^_^