| Levosimendan vs. dobutamine: outcomes for acute heart failure patients on beta-blockers in SURVIVE. | |
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MedLine Citation:
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PMID: 19158152 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Many chronic heart failure (CHF) patients take beta-blockers. When such patients are hospitalized for decompensation, it remains unclear how ongoing beta-blocker treatment will affect outcomes of acute inotrope therapy. We aimed to assess outcomes of SURVIVE patients who were on beta-blocker therapy before receiving a single intravenous infusion of levosimendan or dobutamine. METHODS AND RESULTS: Cox proportional hazard regression revealed all-cause mortality benefits of levosimendan treatment over dobutamine when the SURVIVE population was stratified according to baseline presence/absence of CHF history and use/non-use of beta-blocker treatment at baseline. All-cause mortality was lower in the CHF/levosimendan group than in the CHF/dobutamine group, showing treatment differences by hazard ratio (HR) at days 5 (3.4 vs. 5.8%; HR, 0.58, CI 0.33-1.01, P = 0.05) and 14 (7.0 vs. 10.3%; HR, 0.67, CI 0.45-0.99, P = 0.045). For patients who used beta-blockers (n = 669), mortality was significantly lower for levosimendan than dobutamine at day 5 (1.5 vs. 5.1% deaths; HR, 0.29; CI 0.11-0.78, P = 0.01). CONCLUSION: Levosimendan may be better than dobutamine for treating patients with a history of CHF or those on beta-blocker therapy when they are hospitalized with acute decompensations. These findings are preliminary but important for planning future studies. |
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Authors:
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Alexandre Mebazaa; Markku S Nieminen; Gerasimos S Filippatos; John G Cleland; Jeffrey E Salon; Roopal Thakkar; Robert J Padley; Bidan Huang; Alain Cohen-Solal |
Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2009-01-21 |
Journal Detail:
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Title: European journal of heart failure Volume: 11 ISSN: 1388-9842 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-02-20 Completed Date: 2009-05-12 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 304-11 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology and Critical Care Medicine, Hôpital Lariboisière, APHP; Université Paris 7 Paris Diderot; U 942 INSERM, 2 rue Ambroise-Paré, Paris Cedex 10 75475, France. alexandre.mebazaa@lrb.aphp.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adrenergic beta-Antagonists / therapeutic use* Aged Cardiotonic Agents / administration & dosage, therapeutic use* Cause of Death / trends Dobutamine / administration & dosage, therapeutic use* Dose-Response Relationship, Drug Double-Blind Method Drug Therapy, Combination Female Follow-Up Studies Heart Failure / drug therapy*, mortality, physiopathology Humans Hydrazones / administration & dosage, therapeutic use* Infusions, Intravenous Male Middle Aged Pyridazines / administration & dosage, therapeutic use* Stroke Volume / drug effects Survival Rate / trends Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan; 34368-04-2/Dobutamine |
| Comments/Corrections | |
Comment In:
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Eur J Heart Fail. 2010 Aug;12(8):893
[PMID:
20675671
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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