Document Detail


Levosimendan neither improves nor worsens mortality in patients with cardiogenic shock due to ST-elevation myocardial infarction.
MedLine Citation:
PMID:  20859537     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to evaluate the effect of levosimendan on mortality in cardiogenic shock (CS) after ST elevation myocardial infarction (STEMI).
METHODS AND RESULTS: Data were obtained prospectively from the SCAAR (Swedish Coronary Angiography and Angioplasty Register) and the RIKS-HIA (Register of Information and Knowledge about Swedish Heart Intensive Care Admissions) about 94 consecutive patients with CS due to STEMI. Patients were classified into levosimendan-mandatory and levosimendan-contraindicated cohorts. Inotropic support with levosimendan was mandatory in all patients between January 2004 and December 2005 (n = 46). After the SURVIVE and REVIVE II studies were presented, levosimendan was considered contraindicated and was not used in consecutive patients between December 2005 and December 2006 (n = 48). The cohorts were similar with respect to pre-treatment characteristics and concomitant medications. There was no difference in the incidence of new-onset atrial fibrillation, in-hospital cardiac arrest and length of stay at the coronary care unit. There was no difference in adjusted mortality at 30 days and at one year.
CONCLUSION: The use of levosimendan neither improves nor worsens mortality in patients with CS due to STEMI. Well-designed randomized clinical trials are needed to define the role of inotropic therapy in the treatment of CS.
Authors:
Elmir Omerovic; Truls Råmunddal; Per Albertsson; Mikael Holmberg; Per Hallgren; Jan Boren; Lars Grip; Göran Matejka
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-07
Journal Detail:
Title:  Vascular health and risk management     Volume:  6     ISSN:  1178-2048     ISO Abbreviation:  Vasc Health Risk Manag     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-22     Completed Date:  2010-12-03     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101273479     Medline TA:  Vasc Health Risk Manag     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  657-63     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. elmir@wlab.gu.se
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Atrial Fibrillation / etiology
Cardiotonic Agents / therapeutic use*
Chi-Square Distribution
Cohort Studies
Electrocardiography
Female
Heart Arrest / etiology
Humans
Hydrazones / therapeutic use*
Length of Stay
Male
Myocardial Infarction / complications,  drug therapy*,  mortality
Myocardial Revascularization
Proportional Hazards Models
Pyridazines / therapeutic use*
Sex Factors
Shock, Cardiogenic / drug therapy*,  etiology,  mortality
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 349552KRHK/simendan
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