Superiority of Long-Acting to Short-Acting Loop Diuretics in the Treatment of Congestive Heart Failure : The J-MELODIC Study




    • MASUYAMA Tohru
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • TSUJINO Takeshi
    • Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences
    • ORIGASA Hideki
    • Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine
    • YAMAMOTO Kazuhiro
    • Division of Molecular Medicine and Therapeutics, Department of Multidiscipinary Internal Medicine, Faculty of Medicine Tottori University
    • HIRANO Yutaka
    • Division of Central Clinical Laboratory, Kinki University School of Medicine
    • OHTE Nobuyuki
    • Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences
    • DAIMON Takashi
    • Division of Biostatistics, Department of Mathematics, Hyogo College of Medicine
    • NAKATANI Satoshi
    • Department of Health Sciences, Osaka University Graduate School of Medicine
    • ITO Hiroshi
    • Department of Cardiovascular Medicine, Akita University Graduate School of Medicine


<b><i>Background:</i></b> 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). <b><i>Methods and Results:</i></b> 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). <b><i>Conclusions:</i></b> Azosemide, compared with furosemide, reduced the risk of cardiovascular death or unplanned admission to hospital for congestive HF. (<i>Circ J</i> 2012; <b>76:</b> 833-842)<br>


  • Circulation journal : official journal of the Japanese Circulation Society

    Circulation journal : official journal of the Japanese Circulation Society 76(4), 833-842, 2012-03-25

    The Japanese Circulation Society

参考文献:  30件中 1-30件 を表示

被引用文献:  1件中 1-1件 を表示


  • 本文言語コード
  • 資料種別
  • ISSN
  • データ提供元
    CJP書誌  CJP引用  J-STAGE