Abstract
Objectives: 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. Design: A meta-analysis. Setting: Hospitals. Participants: A total of 139 patients from 5 randomized controlled studies were included in the analysis. Interventions: None. Measurments and Main 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.
| Original language | English |
|---|---|
| Pages (from-to) | 474-478 |
| Number of pages | 5 |
| Journal | Journal of Cardiothoracic and Vascular Anesthesia |
| Volume | 23 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Aug 2009 |
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Keywords
- cardiac biomarker
- cardiac surgery
- inotropic drug
- levosimendan
- meta-analysis
- troponin
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Anesthesiology and Pain Medicine
Cite this
Levosimendan Reduces Cardiac Troponin Release After Cardiac Surgery : A Meta-analysis of Randomized Controlled Studies. / Zangrillo, Alberto; Biondi-Zoccai, Giuseppe; Mizzi, Anna; Bruno, Giovanna; Bignami, Elena; Gerli, Chiara; De Santis, Vincenzo; Tritapepe, Luigi; Landoni, Giovanni.
In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 23, No. 4, 08.2009, p. 474-478.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Levosimendan Reduces Cardiac Troponin Release After Cardiac Surgery
T2 - A Meta-analysis of Randomized Controlled Studies
AU - Zangrillo, Alberto
AU - Biondi-Zoccai, Giuseppe
AU - Mizzi, Anna
AU - Bruno, Giovanna
AU - Bignami, Elena
AU - Gerli, Chiara
AU - De Santis, Vincenzo
AU - Tritapepe, Luigi
AU - Landoni, Giovanni
PY - 2009/8
Y1 - 2009/8
N2 - Objectives: 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. Design: A meta-analysis. Setting: Hospitals. Participants: A total of 139 patients from 5 randomized controlled studies were included in the analysis. Interventions: None. Measurments and Main 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.
AB - Objectives: 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. Design: A meta-analysis. Setting: Hospitals. Participants: A total of 139 patients from 5 randomized controlled studies were included in the analysis. Interventions: None. Measurments and Main 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.
KW - cardiac biomarker
KW - cardiac surgery
KW - inotropic drug
KW - levosimendan
KW - meta-analysis
KW - troponin
UR - http://www.scopus.com/inward/record.url?scp=67650545459&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67650545459&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2008.11.013
DO - 10.1053/j.jvca.2008.11.013
M3 - Article
C2 - 19217315
AN - SCOPUS:67650545459
VL - 23
SP - 474
EP - 478
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 4
ER -