Key result
Levosimendan did not significantly reduce all-cause mortality compared to placebo in patients undergoing cardiac surgery (OR 0.76; 95% CI 0.55-1.04; P=0.09).
Why the study?
Does levosimendan reduce all-cause mortality in adult patients undergoing cardiac surgery?
Meta-Analysis (n=2,960)
Does levosimendan reduce all-cause mortality in adult patients undergoing cardiac surgery?
Levosimendan does not significantly reduce all-cause mortality compared to placebo in adult patients undergoing cardiac surgery.
Answers are grounded in this paper and cite their sources.
Does not support routine levosimendan use to reduce mortality after cardiac surgery; confirms neutral effect in meta-analysis of RCTs.
PURPOSE: We sought to determine the impact of levosimendan on mortality following cardiac surgery based on large-scale randomized controlled trials (RCTs). METHODS: We searched PubMed, Web of Science, Cochrane databases, and ClinicalTrials.gov for RCTs published up to December 2017, on levosimendan for patients undergoing cardiac surgery. RESULTS: A total of 25 RCTs enrolling 2960 patients met the inclusion criteria; data from 15 placebo-controlled randomized trials were included for meta-analysis. Pooled analysis showed that the all-cause mortality rate was 6.4% (71 of 1106) in the levosimendan group and 8.4% (93 of 1108) in the placebo group (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.55-1.04; P = 0.09). There were no significant differences between the two groups in the rates of myocardial infarction (OR: 0.91; 95% CI, 0.68-1.21; P = 0.52), serious adverse events (OR: 0.84; 95% CI, 0.66-1.07; P = 0.17), hypotension (OR: 1.69; 95% CI, 0.94-3.03; P = 0.08), and low cardiac output syndrome (OR: 0.47; 95% CI, 0.22-1.02; P = 0.05). CONCLUSION: Levosimendan did not result in a reduction in mortality in adult cardiac surgery patients. Well designed, adequately powered, multicenter trials are necessary to determine the role of levosimendan in adult cardiac surgery.
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Chen et al. (2018) conducted a meta-analysis in Patients undergoing cardiac surgery (n=2,960). Levosimendan vs. Placebo was evaluated on All-cause mortality (OR 0.76, 95% CI 0.55-1.04, p=0.09). Levosimendan did not significantly reduce all-cause mortality compared to placebo in patients undergoing cardiac surgery (OR 0.76; 95% CI 0.55-1.04; P=0.09).
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