Is levosimendan infusion useful in patients with advanced heart failure? Meta-analysis and systematic review
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 ma...
- Autores:
-
Garcia-Pena, A.A.
Buitrago Rodriguez, María Fernanda
Barón, Ana María
Mariño, Alejandro
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2018
- Institución:
- Pontificia Universidad Javeriana
- Repositorio:
- Repositorio Universidad Javeriana
- Idioma:
- eng
- OAI Identifier:
- oai:repository.javeriana.edu.co:10554/56789
- Acceso en línea:
- https://www.sciforschenonline.org/journals/heart/JHH-4-147.php
http://hdl.handle.net/10554/56789
http://dx.doi.org/10.16966/2379-769X.147
- Palabra clave:
- Heart failure
Mortality
Inotropic agent
- Rights
- License
- Atribución-NoComercial 4.0 Internacional
| Summary: | 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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