Long-Term Ambulatory Intravenous Milrinone Therapy in Advanced Heart Failure

Shringi, Sandipan; Joshi, Shiksha; Suffredini, John; Schenk, Ashley; Rajagopalan, Navin; Guglin, Maya

doi:10.1016/j.hlc.2022.09.004

Cited by 1 publication

(2 citation statements)

References 17 publications

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“…Of the remaining 110 studies, 41 met the predetermined inclusion criteria and were therefore included in this review. A total of 41 studies 9,10,13–51 were included in the single-arm meta-analysis, of which 18 RCTs 9,13–29 were included in the network meta-analysis. Figure 1 shows the PRISMA flowchart.…”

Section: Resultsmentioning

confidence: 99%

“…13,15–19,21,23,25,28 Of the 18 randomized controlled trials, 3 (17%) had some degree of bias due to allocation concealment problems, 9,16,23 6 (33%) had some degree of bias due to subject and staff blinding, 9,13,16,19,23,29 and 3 (17%) had other biases. 9,14,26 As shown in Supplemental Digital Content 1 (see Table S3 , http://links.lww.com/JCVP/B74), 23 cohort studies 10,30–51 were of good quality according to the Newcastle‒Ottawa Scale. No bias was indicated for the reporting of BNP and supraventricular tachyarrhythmia in network analysis because the number of trials reporting these outcomes was less than 10 per comparison.…”

Section: Resultsmentioning

confidence: 99%

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Comparative Effectiveness and Safety of Intermittent, Repeated, or Continuous Use of Levosimendan, Milrinone, or Dobutamine in Patients With Advanced Heart Failure: A Network and Single-Arm Meta-analysis

Zhang,

Wang,

Zhang

et al. 2024

Journal of Cardiovascular Pharmacology

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To synthesize the available evidence regarding differences in the long-term safety and efficacy of intermittent, repeated, or continuous palliative inotropic therapy among patients with advanced heart failure (HF). We systematically searched the PubMed, Embase, and Cochrane Library electronic databases, with a cutoff date of November 23, 2023, for studies reporting outcomes in adult patients with advanced HF treated with intermittent, repeated, or continuous levosimendan, milrinone, or dobutamine. Forty-one studies (18 randomized controlled trials and 23 cohort studies) comprising 5137 patients met the inclusion criteria. The results of the network meta-analysis of randomized controlled trials showed that levosimendan had significant advantages over milrinone or dobutamine in reducing mortality and improving LVEF. A single-arm meta-analysis also indicated that levosimendan had the lowest mortality and significantly improved BNP and LVEF. Regarding safety, hypotension events were observed more frequently in the levosimendan group and milrinone groups. However, the current evidence is limited by the heterogeneity and relatively small sample size of the studies.

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Section: Resultsmentioning

confidence: 99%