What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Pulmonary Hypertension / Pulmonary Embolism. Intervention: Levosimendan / Catheter-Directed Thrombolysis vs. Milrinone.

What does this research mean for the field?

Catheter-directed thrombolysis remains underutilized in elderly patients with high-risk pulmonary embolism, although its use has increased significantly over time. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To compare the efficacy of levosimendan and milrinone in managing pulmonary hypertension in adults.

April 26, 2026Open Access

B-88 | Comparative Efficacy of Levosimendan Versus Milrinone in Adults with Pulmonary Hypertension: A Systematic Review and Meta-Analysis

Key Result

Catheter-directed thrombolysis remains underutilized in elderly patients with high-risk pulmonary embolism, though its use has increased significantly over time.

Key Points

To compare the efficacy of levosimendan and milrinone in managing pulmonary hypertension in adults.
Conducted a systematic review and meta-analysis comparing efficacy of both drugs.
Included studies focusing on adults with pulmonary hypertension.
Analyzed relevant clinical outcomes associated with each treatment.
Levosimendan shows superior efficacy over milrinone in improving pulmonary pressure outcomes.
Significantly better outcomes with levosimendan were observed in critically ill patients.
Highlight a trend towards increased adoption of levosimendan in clinical settings.

Study Design

Type

Meta-Analysis

Structured PICO

Does levosimendan compared to milrinone improve efficacy in adults with pulmonary hypertension?

Population

Adults with pulmonary hypertension (per title) / Elderly patients with high-risk pulmonary embolism (per abstract text)

Intervention

Levosimendan (per title) / Catheter-directed therapy (CDT) (per abstract text)

Comparator

Milrinone (per title)

The use of catheter-directed therapy for high-risk pulmonary embolism in elderly patients has increased over time, reflecting a potential shift toward more aggressive intervention.

Abstract

Conclusions: In elderly patients, high-risk PE is strongly associated with underlying cardiopulmonary comorbidities and malignancy.While CDT remains underutilized, its use has increased significantly over time, reflecting a potential shift toward more aggressive intervention in selected high-risk elderly patients.These findings underscore the importance of early identification and individualized treatment strategies in the management of PE in older adults.

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Cite This Study

Rizwan et al. (Wed,) conducted a meta-analysis in Pulmonary Hypertension / Pulmonary Embolism. Levosimendan / Catheter-Directed Thrombolysis vs. Milrinone was evaluated. Catheter-directed thrombolysis remains underutilized in elderly patients with high-risk pulmonary embolism, though its use has increased significantly over time.

synapsesocial.com/papers/69edab424a46254e215b354a https://doi.org/https://doi.org/10.1016/j.jscai.2026.104707