Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies

Giovanni Landoni, Giuseppe Biondi-Zoccai, Massimiliano Greco, Teresa Greco, Elena Bignami, Andrea Morelli, Fabio Guarracino, Alberto Zangrillo

Research output: Contribution to journalArticle

147 Citations (Scopus)

Abstract

Objective: Catecholaminergic inotropes have a place in the management of low output syndrome and decompensated heart failure but their effect on mortality is debated. Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. A meta-analysis was conducted to determine the impact of levosimendan on mortality and hospital stay. Data Sources: BioMedCentral, PubMed, Embase, and the Cochrane Central Register of clinical trials were searched for pertinent studies. International experts and the manufacturer were contacted. Study Selection: Articles were assessed by four trained investigators, with divergences resolved by consensus. Inclusion criteria were random allocation to treatment and comparison of levosimendan vs. control. There were no restrictions on dose or time of levosimendan administration or on language. Exclusion criteria were: duplicate publications, nonadult studies, oral administration of levosimendan, and no data on main outcomes. Data Extraction: Study end points, main outcomes, study design, population, clinical setting, levosimendan dosage, and treatment duration were extracted. Data Synthesis: Data from 5,480 patients in 45 randomized clinical trials were analyzed. The overall mortality rate was 17.4% (507 of 2,915) among levosimendan-treated patients and 23.3% (598 of 2,565) in the control group (risk ratio 0.80 [0.72; 0.89], p for effect

Original languageEnglish
Pages (from-to)634-646
Number of pages13
JournalCritical Care Medicine
Volume40
Issue number2
DOIs
Publication statusPublished - Feb 2012

Fingerprint

Meta-Analysis
Hospitalization
Mortality
Duplicate Publication
Information Storage and Retrieval
Random Allocation
simendan
PubMed
Oral Administration
Length of Stay
Consensus
Language
Randomized Controlled Trials
Heart Failure
Odds Ratio
Research Personnel
Outcome Assessment (Health Care)
Clinical Trials
Oxygen
Calcium

Keywords

  • anesthesia
  • cardiac surgery
  • heart failure
  • inotropic support
  • intensive care
  • levosimendan
  • mortality
  • survival

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies. / Landoni, Giovanni; Biondi-Zoccai, Giuseppe; Greco, Massimiliano; Greco, Teresa; Bignami, Elena; Morelli, Andrea; Guarracino, Fabio; Zangrillo, Alberto.

In: Critical Care Medicine, Vol. 40, No. 2, 02.2012, p. 634-646.

Research output: Contribution to journalArticle

Landoni, Giovanni ; Biondi-Zoccai, Giuseppe ; Greco, Massimiliano ; Greco, Teresa ; Bignami, Elena ; Morelli, Andrea ; Guarracino, Fabio ; Zangrillo, Alberto. / Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies. In: Critical Care Medicine. 2012 ; Vol. 40, No. 2. pp. 634-646.
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