Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty.
BACKGROUND
Cardiogenic shock (CS) after ST elevation myocardial infarction (STEMI) worsens patient's outcome. Levosimendan treatment offers short-term survival benefit in acute heart failure but its effect on long-term outcome remains unclear. We sought to assess the effect on long-term survival of levosimendan compared to dobutamine treatment in patients with STEMI revascularized by primary coronary angioplasty (PCI) who subsequently developed CS.


RESULTS
Twenty-two consecutive STEMI patients with CS after PCI randomized to receive levosimendan or dobutamine treatment for 24 h were followed-up for twelve months. Complete follow-up was obtained in 100% of them. The endpoint was cardiac death. Baseline clinical and haemodynamic characteristics were similar in both groups. The probability of survival calculated with Kaplan-Meier curves analysis showed no statistically significant differences between both groups (p=0.24).


CONCLUSIONS
Levosimendan compared to dobutamine did not improve long-term survival in STEMI patients revascularized by PCI who developed CS.
Samimi-Fard
Sima
S
García-González
Martín J
MJ
Domínguez-Rodríguez
Alberto
A
Abreu-González
Pedro
P
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004280:Dobutamine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy*; D016016:Proportional Hazards Models; D011724:Pyridazines / Q000627:therapeutic use*; D012770:Shock, Cardiogenic / Q000188:drug therapy* / Q000209:etiology; D000077464:Simendan; D015996:Survival Rate; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications
D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004280:Dobutamine