Key result
Intermittent levosimendan infusion reduces mortality ~55% in advanced heart failure.
Why the study?
Evidence remains controversial regarding intermittent levosimendan infusion in patients with advanced heart failure who are not candidates for heart transplantation or left ventricular assist devices.
Does intermittent levosimendan infusion reduce mortality in patients with advanced heart failure?
Meta-Analysis (n=586)
Does intermittent levosimendan infusion reduce mortality in patients with advanced heart failure?
Intermittent levosimendan infusion significantly reduces mortality in patients with advanced heart failure, offering a promising treatment alternative.
Supports intermittent levosimendan in advanced HF; confirms mortality benefit across 11 pooled RCTs.
Background: Heart failure is a growing problem with a progressive increase in the number of patients as a result of better treatment outcomes and medical interventions.Patients with advanced heart failure who are not candidates for heart transplantation or left ventricular assist device become a major challenge for the health system, as they have a high mortality and hospitalization rate.Intermittent levosimendan infusion has been used in this group of patients even though the evidence is still controversial.Objective: The purpose of this study is to determine the efficacy of intermittent levosimendan infusion in patients with advanced heart failure. Methods:We conducted a systematic review of the literature on EMBASE, EPISTEMONIKOS, MEDLINE/Pubmed and Trip database until January 2018.We included published randomized clinical trials and meta-analysis without language restriction.Results: Eleven studies including 586 patients evaluating intermittent levosimendan infusions in patients with advanced heart failure were included for evaluation.After a follow up period between 3 and 12 months there was a 55% reduction in mortality Odds Ratio (OR) 0.45 CI 95% (0.26; 0.78.p<0.003), a reduction in natriuretic peptide levels and an improvement in left ventricular ejection fraction without a reduction in hospitalization rates.Conclusions: Intermittent levosimendan infusions in patients with advanced heart failure showed significant benefit in patients with advanced heart failure with mortality reduction becoming a promising alternative in the treatment of this group of patients.
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AA et al. (2019) conducted a meta-analysis in Advanced heart failure (n=586). Intermittent levosimendan infusion was evaluated on Mortality (OR 0.45, 95% CI 0.26-0.78, p=<0.003). Intermittent levosimendan infusion in patients with advanced heart failure reduced mortality by 55% (OR 0.45; 95% CI 0.26-0.78; p<0.003) over a 3 to 12 month follow-up.
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