Levosimendan in patients with cardiogenic shock complicating myocardial infarction: A meta-analysis

Fang, Mingliang; Cao, Hongxin; Wang, Z.

doi:10.1016/j.medin.2017.08.009

Cited by 25 publications

(5 citation statements)

References 27 publications

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“…However, the randomized Survive [6] study that compared levosimendan to dobutamine in ADHF did not show a difference in outcome. In a recent meta-analysis [21] including CS and ADHF related to a myocardial infarction, levosimendan was associated with an improvement in cardiac output and ScVO2 but mortality was unchanged compared to standard therapies or placebo. These results agree with recent randomized clinical trials [22][23][24] that failed to demonstrate a benefit in perioperative low-cardiac output syndrome.…”

Section: Discussionmentioning

confidence: 99%

Levosimendan Plus Dobutamine in Acute Decompensated Heart Failure Refractory to Dobutamine

Juguet

Fard

Faivre

et al. 2020

JCM

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Randomized studies showed that Dobutamine and Levosimendan have similar impact on outcome but their combination has never been assessed in acute decompensated heart failure (ADHF) with low cardiac output. This is a retrospective, single-center study that included 89 patients (61 ± 15 years) admitted for ADHF requiring inotropic support. The first group consisted of patients treated with dobutamine alone (n = 42). In the second group, levosimendan was administered on top of dobutamine, when the superior vena cava oxygen saturation (ScVO2) remained <60% after 3 days of dobutamine treatment (n = 47). The primary outcome was the occurrence of major cardiovascular events (MACE) at 6 months, defined as all cause death, heart transplantation or need for mechanical circulatory support. Baseline clinical characteristics were similar in both groups. At day-3, the ScVO2 target (>60%) was reached in 36% and 32% of patients in the dobutamine and dobutamine-levosimendan group, respectively. After adding levosimendan, 72% of the dobutamine-levosimendan-group reached the ScVO2 target value at dobutamine weaning. At six months, 42 (47%) patients experienced MACE (n = 29 for death). MACE was less frequent in the dobutamine-levosimendan (32%) than in the dobutamine-group (64%, p = 0.003). Independent variables associated with outcome were admission systolic blood pressure and dobutamine-levosimendan strategy (OR = 0.44 (0.23–0.84), p = 0.01). In conclusion, levosimendan added to dobutamine may improve the outcome of ADHF refractory to dobutamine alone.

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Section: Discussionmentioning

confidence: 99%

Levosimendan Plus Dobutamine in Acute Decompensated Heart Failure Refractory to Dobutamine

Juguet

Fard

Faivre

et al. 2020

JCM

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“…[ 7 ] Levosimendan, as a calcium sensitizer, is another attractive inotrope for cardiogenic shock in sepsis-induced cardiomyopathy. [ 15 ] Unlike other inotropic agents, the positive inotropic effect of levosimendan is independent of the production of cyclic adenosine monophosphate, so it could minimize oxygen demand, arrhythmia, and catecholamines resistance. This property is of great significance for myocardial inhibition in septic patients under the hyperdynamic metabolic state.…”

Section: Discussionmentioning

confidence: 99%

Comparison of dobutamine and levosimendan for treatment of sepsis-induced cardiac dysfunction

Guo

Zhang²,

Zhu³

et al. 2022

Medicine

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Background: Levosimendan and dobutamine are extensively used to treat sepsis-induced cardiomyopathy. Previous studies on whether levosimendan is superior to dobutamine are still controversial. We performed a protocol for systematic review and metaanalysis to compare the efficacy and safety of levosimendan versus dobutamine for the treatment of sepsis-induced cardiomyopathy.Methods: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol statement. We will search the following databases: PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Weipu Journal Database, and Chinese Biomedical Literature Database. The search time will be set from database establishment to February 2022. After literature screening, 2 reviewers will extract data from the respects of general information, methodology, and results. Risk of bias is assessed using the Cochrane Risk of Bias Tool for randomized controlled trials. We will apply RevMan 5.4 software for statistical analysis.

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“…However, data on the impact of levosimendan on survival in CS are not conclusive. 41,103,104 In a recent Cochrane meta-analysis including 19 randomized trials enrolling patients with CS or low CO syndrome, no clear benefit of levosimendan versus dobutamine, enoximone or placebo was observed. 105 Important, the overall quality of evidence was limited with a high risk of bias and imprecision.…”

Section: Levosimendanmentioning

confidence: 99%

Medical therapy of cardiogenic shock: Contemporary use of inotropes and vasopressors

Riccardi,

Pagnesi,

Chioncel

et al. 2024

European J of Heart Fail

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Cardiogenic shock is a primary cardiac disorder that results in both clinical and biochemical evidence of tissue hypoperfusion and can lead to multi‐organ failure and death depending on its severity. Inadequate cardiac contractility or cardiac power secondary to acute myocardial infarction remains the most frequent cause of cardiogenic shock, although its contribution has declined over the past two decades, compared with other causes. Despite some advances in cardiogenic shock management, this clinical syndrome is still burdened by an extremely high mortality. Its management is based on immediate stabilization of haemodynamic parameters so that further treatment, including mechanical circulatory support and transfer to specialized tertiary care centres, can be accomplished. With these aims, medical therapy, consisting mainly of inotropic drugs and vasopressors, still has a major role. The purpose of this article is to review current evidence on the use of these medications in patients with cardiogenic shock and discuss specific clinical settings with indications to their use.

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Levosimendan in patients with cardiogenic shock complicating myocardial infarction: A meta-analysis

Cited by 25 publications

References 27 publications

Levosimendan Plus Dobutamine in Acute Decompensated Heart Failure Refractory to Dobutamine

Levosimendan Plus Dobutamine in Acute Decompensated Heart Failure Refractory to Dobutamine

Comparison of dobutamine and levosimendan for treatment of sepsis-induced cardiac dysfunction

Medical therapy of cardiogenic shock: Contemporary use of inotropes and vasopressors

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