title: Levosimendan reduces cardiac troponin release after cardiac surgery: a meta-analysis of randomized controlled studies.
abstract: OBJECTIVE
  The authors performed a meta-analysis to investigate the effects of levosimendan in cardiac surgery. Inotropic drugs have never shown beneficial effects on outcome in randomized controlled studies, with the possible exception of levosimendan.
  
  
  METHODS
  A meta-analysis.
  
  
  METHODS
  Hospitals.
  
  
  METHODS
  A total of 139 patients from 5 randomized controlled studies were included in the analysis.
  
  
  METHODS
  None.
  
  
  RESULTS
  Four investigators independently searched BioMedCentral and PubMed. Inclusion criteria were random allocation to treatment, and comparison of levosimendan versus control performed on cardiac surgery patients. Exclusion criteria were duplicate publications, nonhuman experimental studies, and no outcome data. The endpoint was postoperative cardiac troponin release. Levosimendan was associated with a significant reduction in cardiac troponin peak release (weighted mean difference = 2.5 ng/dL [-3.86, -1.14], p = 0.0003) and in time to hospital discharge (weighted mean difference = -1.38 days [-2.78, 0.03], p = 0.05). No other relevant outcome (mortality, myocardial infarction, atrial fibrillation, time on mechanical ventilation, and intensive care unit stay) was improved in those patients receiving levosimendan.
  
  
  CONCLUSIONS
  Levosimendan has cardioprotective effects, resulting in reduced postoperative cardiac troponin release.
authors.affiliation: Department of Cardiothoracic Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.forename: Anna
authors.initials: A
authors.lastname: Mizzi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Bruno
authors.forename: Elena
authors.initials: E
authors.lastname: Bignami
authors.forename: Chiara
authors.initials: C
authors.lastname: Gerli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Santis
authors.forename: Luigi
authors.initials: L
authors.lastname: Tritapepe
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
mesh_terms: D006348:Cardiac Surgical Procedures; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D023381:Endpoint Determination; D006321:Heart / Q000187:drug effects*; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D009206:Myocardium / Q000378:metabolism*; D011184:Postoperative Period; D011724:Pyridazines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D018570:Risk Assessment; D000077464:Simendan; D016896:Treatment Outcome; D014336:Troponin / Q000378:metabolism*
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D014336:Troponin; D000077464:Simendan