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- Title
Wpływ powtarzalnego wlewu lewozymendanu na zmniejszenie częstości rehospitalizacji oraz śmiertelności u pacjentów ze schyłkową niewydolnością serca – badanie pilotażowe.
- Authors
Tycińska, Agnieszka; Wilk, Katarzyna; Gierlotka, Marek; Kazimierczyk, Remigiusz; Szyszkowska, Anna; Gil, Monika; Kamiński, Karol; Sobkowicz, Bożena
- Abstract
AIMS In a pilot study, we aimed to compare single versus double levosimendan infusion in end‑stage heart failure (HF) outpatients on the occurrence of composite end point (CEP)—death or hospitalization due to heart failure (HHF). METHODS In 16 males with HF in stable ambulatory NYHA III/IV (mean age 62 ±9.2 years, mean left ventricle ejection fraction 16 ±6.6%, mean NT‑proBNP 7250 ±4563 pg/ml, 75% ischemic etiology, 63% after CRT‑D implantation) levosimendan (12.5 mg for each administration, with starting dose of 0.05 mg/kg/ min) was given once (n = 6) or twice (mean 2.7 ±1.7 months apart, n = 10). All patients received the most optimal, standard of care ESC‑guided pharmacotherapy, and levosimendan was added electively on top of this therapy. RESULTS Altogether CEP occurred in 9 patients (56%)—7 in a group of repetitive and 2 in a group of single levosimendan use. Mean time to CEP occurrence (after the last drug administration) was 5.8 ±3.2 months. CEP patients had significantly higher baseline NT‑proBNP concentrations (median 10 767 [4744–11070] pg/ml vs. 2247 [1582–5552] pg/ml, P = 0.05). Mean time to CEP occurrence was longer in patients with double levosimendan administration as compared to the single one (7.1 ±3.1 months vs. 3.6 ±1.9 months, P = 0.02, Figure 1). No significant differences regarding survival analysis was found (log‑rank test, P = 0.48). CONCLUSIONS Repetitive levosimendan infusion in a group of no‑option end‑stage HF patients delays the occurrence of HHF or death. This way of drug administration can be offered to the patients with severe systolic dysfunction, mainly due to its unique mechanism of action. However, further randomized studies on larger patients’ population are needed to confirm this finding.
- Subjects
CONFERENCES &; conventions; DEATH; HEART failure; HETEROCYCLIC compounds; PATIENTS; PATIENT readmissions
- Publication
Polish Heart Journal / Kardiologia Polska, 2020, Vol 78, p118
- ISSN
0022-9032
- Publication type
Article