Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty

Samimi-Fard, Sima; García-González, Martín J.; Domínguez‐Rodríguez, Alberto; Abreu-González, Pedro

doi:10.1016/j.ijcard.2007.04.143

Cited by 57 publications

(43 citation statements)

References 11 publications

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“…59 Mild QTc prolongation, no proarrhythmia. 60 Possible survival benefit vs conventional inotropes, 62,63 although not borne out in larger trials. 64 Increases mean APD 50 by 9 to 17 ms and mean APD 90 by 5 to 15 ms in healthy volunteers.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Toxicity for Heart Failure Therapeutics

Link

Yan

Kowey

2010

Circ: Heart Failure

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Section: Resultsmentioning

confidence: 99%

Evaluation of Toxicity for Heart Failure Therapeutics

Link

Yan

Kowey

2010

Circ: Heart Failure

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“…In the LEAF study [23], more episodes of hypotension occurred during the levosimendan infusion when compared to placebo treatment, but there was no significant difference in blood pressure at the end of the infusion when comparing the 2 groups. These small studies [11,12,13,14,23] indicate that levosimendan is a safe drug for use in AMI and does not increase the incidence of myocardial ischemia, mortality or serious arrhythmias. In addition, it appears that levosimendan may decrease the incidence of worsening heart failure and/or mortality.…”

Section: Discussionmentioning

confidence: 99%

“…There are several studies showing that levosimendan is a safe drug for use in patients with AMI and that it does not increase the incidence of myocardial ischemia or other events; these were, however, small studies or case reports. Furthermore, they tended to include special cases, such as those undergoing cardiac surgery or percutaneous coronary intervention, and included only a few patients with nonrevascularization [11,12,13,14,15,16]. Therefore, it is essential that trials examining the safety and clinical efficacy of levosimendan are conducted, with larger sample sizes and including patients with nonrevascularization.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Intravenous Levosimendan in Patients with Heart Failure Complicated by Acute Myocardial Infarction

Jia

Guo²,

Zhang³

et al. 2014

Cardiology

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Objectives: To evaluate the efficacy of a short-term intravenous infusion of levosimendan in patients with heart failure due to acute myocardial infarction (AMI). Methods: This was a randomized, single-center, single-blind study that included 160 patients. Patients were randomly divided into 2 groups: 1 received levosimendan (n = 80) and the other received placebo (n = 80). The study included multiple primary end points (death, myocardial ischemia or worsening heart at the 6 month follow-up) and used a composite outcome. Results: The primary end point rate in the levosimendan group was lower than that in placebo group (43.7 vs. 62.5%, HR 0.636, 95% CI 0.413-0.981, p = 0.041). Moreover, the mortality rate at 6 months was similar between the 2 groups (17.5 vs. 22.5%, HR 0.786, 95% CI 0.382-1.543, p = 0.458). There was a higher incidence of myocardial ischemia in the levosimendan group at 14 days than in the placebo group (11.2 vs. 7.5%, HR 1.510, p = 0.435), but between 15 and 180 days, it was significantly lower in the levosimendan group than in the placebo group (3.8 vs. 13.8%, HR 0.261, p = 0.036). Conclusion: Short-term intravenous infusion of levosimendan appears to be more effective than placebo for treating patients with heart failure complicated by AMI.

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“…The short-term hemodynamic effect was found to be comparable to the IABP outcome. 32 In patients with cardioplegic shock revascularized with levo primary PCI, levosimendan improves LV diastolic functions obtained via Doppler echocardiography; 33 however, it does not improve the long-term mortality. 34 The use of this drug in STEMI cases complicated by cardioplegic shock has been investigated only in small studies (Table 3); therefore further studies are warranted.…”

Section: Use Of Levosimendan In Patients Undergoing Percutaneous Coromentioning

confidence: 99%

Use of levosimendan in patients with ischemic heart disease following mechanical reperfusion

Kurt

2009

Surg Today

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Cardiac failure is among the most significant conditions associated with acute coronary syndrome. In ischemic heart disease, serious hemodynamic problems are reported in patients with left ventricular dysfunction during the acute phase despite mechanical revascularization. Several positive inotropic agents in addition to intra-aortic balloon pump (IABP) are required to support patients with impaired left ventricular pump function during this phase. Intravenous inotropic agents, beta-mimetics, and phosphodiesterase inhibitors lead to increases in the incidence of arrhythmia and myocardial O(2) consumption owing to their effect of increasing intracellular calcium amount, although they produce rapid hemodynamic improvements in cardiac failure. This causes severe problems particularly in cardiac failure of ischemic origin. Recently, levosimendan, a calcium-sensitizing agent with cardioprotective properties, is being used alone or in combination with IABP in cases with severe left ventricular systolic dysfunction during mechanical revascularization procedures (percutaneous coronary interventions, coronary bypass surgery). This review includes studies with levosimendan in cases not recovering due to myocardial stunning in the acute phase despite mechanical approaches applied.

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Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty

Cited by 57 publications

References 11 publications

Evaluation of Toxicity for Heart Failure Therapeutics

Evaluation of Toxicity for Heart Failure Therapeutics

Efficacy of Intravenous Levosimendan in Patients with Heart Failure Complicated by Acute Myocardial Infarction

Use of levosimendan in patients with ischemic heart disease following mechanical reperfusion

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