Key result
Levosimendan infusion reduces 6-month infarct size by ~12% vs placebo in STEMI patients undergoing PCI.
Why the study?
Myocardial reperfusion causes additional cell damage in STEMI, and levosimendan's pleiotropic effects may serve as a therapeutic option to reduce infarct size.
Does a 24-h infusion of levosimendan reduce infarct size in patients with STEMI undergoing primary percutaneous coronary intervention?
RCT (n=157)
Does a 24-h infusion of levosimendan reduce infarct size in patients with STEMI undergoing primary percutaneous coronary intervention?
A 24-hour infusion of levosimendan after primary PCI in STEMI patients significantly reduces infarct size at 6 months compared to placebo, without increasing major adverse cardiovascular events.
Answers are grounded in this paper and cite their sources.
Supports adjunctive levosimendan to limit infarct size in STEMI after PCI; extends RCT evidence beyond acute HF.
BACKGROUND: Primary angioplasty is the standard procedure for patients with ST-segment elevation myocardial infarction (STEMI). However, myocardial reperfusion results in additional cell damage. Levosimendan, due to its pleiotropic effects, may be a therapeutic alternative to prevent this damage. The objective of this study was to evaluate whether this drug can reduce infarct size in patients with STEMI. METHODS: Patients were randomized to receive a 24-h infusion of either levosimendan (0.1 μg/kg/min) or placebo after the primary angioplasty. The main objective was to assess the size of the infarct by cardiac resonance at 30 days and 6 months after the event. Other variables such as left ventricular ejection fraction (LVEF) and adverse ventricular remodeling (AVR) were assessed by speckle-tracking echocardiography and magnetic resonance. Major adverse cardiovascular events (MACE) were also collected. RESULTS: 157 patients were analysed (levosimendan, n = 79; placebo, n = 78). We found that after 6 months, patients treated with levosimendan had a greater reduction in infarct size (13.19% ± 9.5% vs.11.79% ± 9%, p = 0.001), compared with those in the placebo group (13.35% ± 7.1% vs. 13.43% ± 7.8%, p = 0.38). There were no significant differences in MACE between both groups. CONCLUSIONS: Levosimendan is a safe and effective therapeutic option for reducing infarct size in patients with STEMI.
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Ojeda et al. (2024) conducted an RCT in ST-segment elevation myocardial infarction (STEMI) (n=157). Levosimendan vs. Placebo was evaluated on Infarct size by cardiac resonance at 30 days and 6 months (p=0.001). Levosimendan infusion significantly reduced infarct size at 6 months in STEMI patients undergoing primary PCI (13.19% to 11.79%, p=0.001) compared to placebo (13.35% to 13.43%, p=0.38).
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