Cardiothoracic & vascular anesthesia
Levosimendan in Patients With Low Cardiac Ejection Fraction Undergoing Coronary Artery Bypass Grafting: Machine Learning Double Robust Causal Effect Analysis
Main finding · 30-day mortalityResult — go to the resultAverage treatment effect 0.12 percentage points 95% CI −0.84 to 1.56Authors' conclusion
In this study, levosimendan does not significantly impact 30-day mortality in patients undergoing CABG with severely reduced LVEF (≤30%).
Study context
- Population
- Patients with LVEF ≤30% undergoing coronary artery bypass grafting (CABG) with or without concomitant valvular surgery
- Participants
- 973 patients
- Exposure
- Preoperative levosimendan vs no levosimendan
- Outcome
- All-cause mortality
- Follow-up
- 30 days
Methodological detailsmachine learning double-robust causal effect analysis, single institutional database
- Machine learning double-robust causal effect analysis
- Single institutional database
Main finding
30-day mortality
Average treatment effect
0.12 percentage points
95% CI −0.84 to 1.56
As reported in the abstract
Observational data: associations, not effects.
Further findings
30-day mortality, double-robust targeted maximum likelihood estimation (sensitivity analysis)
- Difference, 1.08 percentage points (95% CI, −6.66 to 10.71); null effect consistent
30-day mortality, overlap weighting (sensitivity analysis)
- 0.12 percentage points (95% CI, −0.80 to 1.58); null effect consistent
Original publication
Levosimendan in Patients With Low Cardiac Ejection Fraction Undergoing Coronary Artery Bypass Grafting: Machine Learning Double Robust Causal Effect Analysis. J Cardiothorac Vasc Anesth. Published 26 May 2026. doi:10.
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