Document Detail


Levosimendan in patients with acute myocardial ischaemia undergoing emergency surgical revascularization.
MedLine Citation:
PMID:  17892614     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A Lehmann; A-H Kiessling; F Isgro; C Zeitler; E Thaler; J Boldt
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-09-25
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  25     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-01-29     Completed Date:  2008-03-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  224-9     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany. lehmanna@klilu.de
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MeSH Terms
Descriptor/Qualifier:
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:
0/Anti-Arrhythmia Agents; 0/Catecholamines; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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