Cardiothoracic & vascular anesthesia
Preoperative Levosimendan in Patients With Severe Left Ventricular Dysfunction Undergoing Isolated Coronary Artery Bypass Grafting: A Meta-Analysis of Randomized Controlled Trials
Pooled result · All-cause mortalityResult — go to the resultRelative risk 0.31 95% CI 0.16–0.60Authors' conclusion
Preoperative levosimendan in patients with severe left ventricular dysfunction undergoing isolated coronary artery bypass grafting was associated with reduced all-cause mortality, low-cardiac-output syndrome, acute kidney injury, postoperative atrial fibrillation, and the need for circulatory support without compromising safety.
Study context
- Population
- Patients with severe left ventricular dysfunction (ejection fraction <35%) undergoing isolated CABG
- Participants
- 1,225 patients · 6 RCTs
- Comparison
- Preoperative levosimendan vs placebo or no therapy
- Levosimendann = 615
- Placebo/no therapyn = 610reference
- Outcome
- All-cause mortality
Methodological detailsrandom effects model
- Random effects model
Pooled result
As reported in the abstract
Relative risk
0.31
95% CI 0.16–0.60
P < 0.01
Levosimendan vs Placebo/no therapy
RR 0.31 (95% CI 0.16–0.60); P < 0.01
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Postoperative AKII2 = 0% | 0.44 (0.25–0.77) | P < 0.01 | |
| Low-cardiac-output syndromeI2 = 0% | 0.45 (0.30–0.66) | P < 0.001 | |
| Postoperative AFI2 = 85% | 0.49 (0.25–0.98) | P = 0.04 | |
| 0.20.5125Relative risk (log scale) |
Postoperative inotropes and cardiac index · 24 hours postoperatively
- Levosimendan significantly reduced need for postoperative inotropes and increased cardiac index at 24 h
Safety
Perioperative MI, hypotension, any adverse events
- No differences between groups
Original publication
Preoperative Levosimendan in Patients With Severe Left Ventricular Dysfunction Undergoing Isolated Coronary Artery Bypass Grafting: A Meta-Analysis of Randomized Controlled Trials. J Cardiothorac Vasc Anesth. Published 15 December 2023. doi:10.
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