Safety of chronic heart failure complex therapy: results of randomized crossover study BASTion
Objective To estimate the safety of complex therapy of patients with chronic heart failure after adding to treatment diuretics with different influence on potassium excretion. Materials and methods 19 patients over 18 years with stable chronic heart failure (CHF), II and III NYHA class, were included in randomized crossover study. All patients were administered with standard CHF therapy: β -blocker, angiotensin-converting enzyme (ACE) inhibitor, mineral-corticoid receptor inhibitor and diuretic. Patients’ therapy did not change until one month before randomization. After randomization patients were subdivided into two groups: first group (8 persons) started diurethic therapy with furosemide, second one (11 persons) started diuretic therapy with torasemide. Therapy was estimated after one month and patients who took torasemide started to take furosemide fore one more month and vice versa, patients who previously received furasemide changed it to torasemide. All patients received medicines in necessary doses according with their clinical condition. Results Average age of patients included in the study was 68,2±9,5 years. 52,6% of patients were males. Average dose of torasemide in the study was 24,5±7,4 mg per week, and average dose of furosemide was 111,6±16,8 mg per week. Used average doses of four-component therapy did not lead to occurrence of hyperkaliemic conditions. Results of 6-minute walk tests revealed improved tolerability of physical exercise after torasemide treatment. Torasemide was better tolerated by patients. Conclusion Lack of reflex tachycardia in response to torasemide therapy allows to recommend it for the majority of patients with CHF especially to the ones with comorbid pathologies.