A favorable alliance between repetitive use of levosimendan and advanced heart failure: Polish two-centered inpatient perspective in need of validation

Książczyk, Marcin; Gruchała, Marcin; Stopczyńska, Iwona; Lelonek, Małgorzata

doi:10.33963/kp.a2023.0034

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…Nevertheless, this fact, combined with the well-documented association of LV dysfunction with increased short-and long-term mortality in patients undergoing high-risk PCI [13] may suggest that our treatment protocol may have a positive impact on the outcomes. Notably, compared to other inotropes, levosimendan may reduce not only the symptoms of HF, but also mortality [14].…”

Section: Resultsmentioning

confidence: 99%

High-risk PCI facilitated by levosimendan infusion and Impella CP support in ACS cohort-pilot study

Turkiewicz,

Rola,

Kulczycki

et al. 2024

Pol Heart J

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Section: Resultsmentioning

confidence: 99%

High-risk PCI facilitated by levosimendan infusion and Impella CP support in ACS cohort-pilot study

Turkiewicz,

Rola,

Kulczycki

et al. 2024

Pol Heart J

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Repeated Levosimendan Infusions in the Management of Advanced Heart Failure: Review of the Evidence and Meta-analysis of the Effect on Mortality

Silvetti,

Pollesello,

Belletti

2023

Journal of Cardiovascular Pharmacology

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In the latest years several studies described the impact of repetitive/intermittent i.v levosimendan treatment in the management of advanced heart failure. For this updated review we systematically searched the literature for clinical trials, registries, and real-world data, and identified 31 studies that we commented in a narrative review: 3814 patients were described, of whom 1744 were treated repetitively with levosimendan. On the basis of the nature of the study protocols and of the end-points, out of those studies we further selected 9 that had characteristics making them suitable for a meta-analysis on mortality. This short list describes data from 680 patients (of whom 399 received repeated doses of levosimendan), and 110 death events (of which 50 occurred in the levosimendan cohort). In the meta-analysis, repetitive/intermittent therapy with i.v. levosimendan was associated with a significant reduction in mortality at the longest time-point available: 50/399 (12.5%) versus 60/281 (21.4%) in the control arms, with a risk ratio of 0.62 (95% confidence interval = 0.42–0.90; p<0.01). In a sensitivity analysis, removing each trial and re-analysing the remaining dataset did not change either the trend, magnitude, or significance of the results. A visual inspection of the funnel plot did not suggest publication bias. The results provide a very strong rationale for continuing to investigate the repetitive use of levosimendan in patients with advanced heart failure by properly powered regulatory clinical trials. Meanwhile, it seems that the use of repetitive/intermittent i.v. levosimendan infusions has become one of the few effective options for preserving the hemodynamic and symptomatic balance in such patients.

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A favorable alliance between repetitive use of levosimendan and advanced heart failure: Polish two-centered inpatient perspective in need of validation

Cited by 2 publications

References 15 publications

High-risk PCI facilitated by levosimendan infusion and Impella CP support in ACS cohort-pilot study

High-risk PCI facilitated by levosimendan infusion and Impella CP support in ACS cohort-pilot study

Repeated Levosimendan Infusions in the Management of Advanced Heart Failure: Review of the Evidence and Meta-analysis of the Effect on Mortality

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