Abstract
Aims: Standard inotropic treatment is often necessary in end-stage heart failure but may be harmful. We performed a meta-analysis of randomized controlled trials to investigate the effect of repeated administration of levosimendan on survival in patients with chronic heart failure. Methods and results: Four investigators independently searched in CENTRAL, Google Scholar MEDLINE/PubMed, Scopus and the Cochrane Central Register of clinical trials to identify any randomized study ever performed with intermittent levosimendan intravenous administration in adult patients with chronic heart failure with no restrictions on dose or time of administration. Data from a total of 326 patients from six randomized controlled studies using intermittent levosimendan in a cardiological setting were included in the analysis. Levosimendan was associated with a significant reduction in mortality at the longest follow-up available [32 of 168 (19 %) in the levosimendan group 46 of 133 (35 %) in the control arm, RR = 0.55 (95 % CI 0.37-0.84), p for effect = 0 0.005, p for heterogeneity = 0.3, I 2 = 23.4 %, NNT = 6 with 5 studies included]. Brain natriuretic peptide values, ejection fraction and number of patients with New York Heart Association ≥III status were similar in survivors of both groups. Conclusions: A large randomized trial is necessary to confirm the promising beneficial effects of intermittent levosimendan administration on the mid-term survival of patients with chronic heart failure.
| Original language | English |
|---|---|
| Pages (from-to) | 505-513 |
| Number of pages | 9 |
| Journal | Clinical Research in Cardiology |
| Volume | 103 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- Chronic heart failure
- Intermittent administration
- Levosimendan
- Survival
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Medicine(all)
Cite this
Intermittent levosimendan improves mid-term survival in chronic heart failure patients : Meta-analysis of randomised trials. / Silvetti, Simona; Greco, Teresa; Di Prima, Ambra Licia; Mucchetti, Marta; De Lurdes, Castro Maria; Pasin, Laura; Scandroglio, Mara; Landoni, Giovanni; Zangrillo, Alberto.
In: Clinical Research in Cardiology, Vol. 103, No. 7, 2014, p. 505-513.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intermittent levosimendan improves mid-term survival in chronic heart failure patients
T2 - Meta-analysis of randomised trials
AU - Silvetti, Simona
AU - Greco, Teresa
AU - Di Prima, Ambra Licia
AU - Mucchetti, Marta
AU - De Lurdes, Castro Maria
AU - Pasin, Laura
AU - Scandroglio, Mara
AU - Landoni, Giovanni
AU - Zangrillo, Alberto
PY - 2014
Y1 - 2014
N2 - Aims: Standard inotropic treatment is often necessary in end-stage heart failure but may be harmful. We performed a meta-analysis of randomized controlled trials to investigate the effect of repeated administration of levosimendan on survival in patients with chronic heart failure. Methods and results: Four investigators independently searched in CENTRAL, Google Scholar MEDLINE/PubMed, Scopus and the Cochrane Central Register of clinical trials to identify any randomized study ever performed with intermittent levosimendan intravenous administration in adult patients with chronic heart failure with no restrictions on dose or time of administration. Data from a total of 326 patients from six randomized controlled studies using intermittent levosimendan in a cardiological setting were included in the analysis. Levosimendan was associated with a significant reduction in mortality at the longest follow-up available [32 of 168 (19 %) in the levosimendan group 46 of 133 (35 %) in the control arm, RR = 0.55 (95 % CI 0.37-0.84), p for effect = 0 0.005, p for heterogeneity = 0.3, I 2 = 23.4 %, NNT = 6 with 5 studies included]. Brain natriuretic peptide values, ejection fraction and number of patients with New York Heart Association ≥III status were similar in survivors of both groups. Conclusions: A large randomized trial is necessary to confirm the promising beneficial effects of intermittent levosimendan administration on the mid-term survival of patients with chronic heart failure.
AB - Aims: Standard inotropic treatment is often necessary in end-stage heart failure but may be harmful. We performed a meta-analysis of randomized controlled trials to investigate the effect of repeated administration of levosimendan on survival in patients with chronic heart failure. Methods and results: Four investigators independently searched in CENTRAL, Google Scholar MEDLINE/PubMed, Scopus and the Cochrane Central Register of clinical trials to identify any randomized study ever performed with intermittent levosimendan intravenous administration in adult patients with chronic heart failure with no restrictions on dose or time of administration. Data from a total of 326 patients from six randomized controlled studies using intermittent levosimendan in a cardiological setting were included in the analysis. Levosimendan was associated with a significant reduction in mortality at the longest follow-up available [32 of 168 (19 %) in the levosimendan group 46 of 133 (35 %) in the control arm, RR = 0.55 (95 % CI 0.37-0.84), p for effect = 0 0.005, p for heterogeneity = 0.3, I 2 = 23.4 %, NNT = 6 with 5 studies included]. Brain natriuretic peptide values, ejection fraction and number of patients with New York Heart Association ≥III status were similar in survivors of both groups. Conclusions: A large randomized trial is necessary to confirm the promising beneficial effects of intermittent levosimendan administration on the mid-term survival of patients with chronic heart failure.
KW - Chronic heart failure
KW - Intermittent administration
KW - Levosimendan
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=84902796549&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84902796549&partnerID=8YFLogxK
U2 - 10.1007/s00392-013-0649-z
DO - 10.1007/s00392-013-0649-z
M3 - Article
C2 - 24368740
AN - SCOPUS:84902796549
VL - 103
SP - 505
EP - 513
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
SN - 1861-0684
IS - 7
ER -