| Levosimendan in patients with acute myocardial ischaemia undergoing emergency surgical revascularization. | |
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MedLine Citation:
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PMID: 17892614 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVE: Levosimendan is a calcium-sensitizing drug that enhances myocardial contractility without increasing intracellular calcium. By activating adenosine triphosphate-dependent potassium channels it exerts cardioprotective and vasodilatory effects. METHODS: A retrospective matched pair analysis was performed in 52 patients undergoing emergency coronary artery bypass grafting for acute myocardial ischaemia with or without cardiogenic shock. A total of 27 patients received levosimendan (bolus 6 microg kg(-1); continuous infusion 0.2 microg kg(-1) min(-1)) in addition to catecholamines, while 25 patients were treated with catecholamines only. RESULTS: Predicted mortality by logistic EuroSCORE was 42% (14-90%) in the levosimendan group and 38% (9-90%) in the control group (median, range). Cardiogenic shock was diagnosed in 52% of the patients in both groups. Compared to the control group, levosimendan-treated patients had fewer intra-aortic balloon pumps inserted (33% vs. 76%, P 0.05) and need for dialysis (11% levosimendan; 32% control, P > 0.05) did not reach statistical significance. Length of hospital stay did not differ (14 +/- 18 days, levosimendan; 13 +/- 19 days, control; P > 0.05) between the two groups. CONCLUSION: In this retrospective matched pair analysis of 52 patients undergoing emergency coronary artery bypass grafting for acute ischaemia, levosimendan reduced morbidity. The reduced morbidity did not translate into reductions in mortality or length of stay. A larger, prospective randomized trial is warranted to confirm the potentially beneficial effects of levosimendan in patients with acute ischaemia. |
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Authors:
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A Lehmann; A-H Kiessling; F Isgro; C Zeitler; E Thaler; J Boldt |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-09-25 |
Journal Detail:
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Title: European journal of anaesthesiology Volume: 25 ISSN: 1365-2346 ISO Abbreviation: Eur J Anaesthesiol Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-01-29 Completed Date: 2008-03-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8411711 Medline TA: Eur J Anaesthesiol Country: England |
Other Details:
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Languages: eng Pagination: 224-9 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany. lehmanna@klilu.de |
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Anti-Arrhythmia Agents / therapeutic use* Blood Pressure / drug effects Case-Control Studies Catecholamines / administration & dosage Cohort Studies Coronary Artery Bypass / methods Emergencies Female Heart Rate / drug effects Humans Hydrazones / therapeutic use* Infusions, Intravenous Intra-Aortic Balloon Pumping Length of Stay Male Middle Aged Monitoring, Intraoperative Myocardial Ischemia / complications*, therapy Myocardial Revascularization / methods* Pyridazines / therapeutic use* Respiration, Artificial Retrospective Studies Shock, Cardiogenic / etiology, therapy Survival Rate Vascular Resistance / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 0/Catecholamines; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan |
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