Calcium Sensitizer Offers No Hemodynamic Benefit After Cardiac Surgery

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Low-dose levosimendan in addition to standard care did not result in lower 30-day mortality compared with placebo in patients requiring hemodynamic support post-cardiac surgery.
Low-dose levosimendan in addition to standard care did not result in lower 30-day mortality compared with placebo in patients requiring hemodynamic support post-cardiac surgery.

HealthDay News — For patients undergoing hemodynamic support after cardiac surgery, levosimendan is not associated with lower 30-day mortality versus placebo, according to a study published in the New England Journal of Medicine

The research was published to coincide with the annual International Symposium on Intensive Care and Emergency Medicine, held from March 21 to 24 in Brussels.

Giovanni Landoni, MD, from the San Raffaele Scientific Institute in Milan, and colleagues conducted a multicenter trial involving patients in whom hemodynamic support was indicated after cardiac surgery (ClinicalTrials.gov Identifier: NCT00994825). 

Patients were randomized to receive levosimendan or placebo for up to 48 hours or until discharge from the intensive care unit, as well as standard care.

After 506 patients were enrolled the trial was stopped for futility. Two hundred forty-eight patients were randomized to levosimendan and 258 to placebo. The researchers observed no significant between-group difference in 30-day mortality (12.9% versus 12.8% for the levosimendan and placebo groups, respectively). 

No significant between-group differences were seen in the duration of mechanical ventilation, intensive care unit stay, or hospital stay. The rates of hypotension and cardiac arrhythmias did not differ between the groups.

"In patients who required perioperative hemodynamic support after cardiac surgery, low-dose levosimendan in addition to standard care did not result in lower 30-day mortality than placebo," the authors write.

Study funded by the Italian Ministry of Health.

Reference

Landoni G, Lomivorotov VV, Alvaro G, et al. Levosimendan for hemodynamic support after cardiac surgery [published online March 21, 2017] N Engl J Med. doi: 10.1056/NEJMoa1616325

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