Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2024
Efficacy and safety of levosimendan in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: The LEVOCEST trial.
СтатьяРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Bosa Ojeda Francisco, Méndez Vargas Corabel, Lacalzada Almeida Juan, Izquierdo Gómez María M, Jiménez Sosa Alejandro, Rodríguez Jiménez Consuelo, Sánchez-Grande Flecha Alejandro, Bosa Santana Marta, Yanes Bowden Geoffrey
Аннотация
BACKGROUND: Primary angioplasty is the standard procedure for patients with ST-segment elevation myocardial infarction (STEMI). However, myocardial reperfusion results in additional cell damage. Levosimendan, due to its pleiotropic effects, may be a therapeutic alternative to prevent this damage. The objective of this study was to evaluate whether this drug can reduce infarct size in patients with STEMI.
METHODS: Patients were randomized to receive a 24-h infusion of either levosimendan (0.1 μg/kg/min) or placebo after the primary angioplasty. The main objective was to assess the size of the infarct by cardiac resonance at 30 days and 6 months after the event. Other variables such as left ventricular ejection fraction (LVEF) and adverse ventricular remodeling (AVR) were assessed by speckle-tracking echocardiography and magnetic resonance. Major adverse cardiovascular events (MACE) were also collected.
RESULTS: 157 patients were analysed (levosimendan, n = 79; placebo, n = 78). We found that after 6 months, patients treated with levosimendan had a greater reduction in infarct size (13.19% ± 9.5% vs.11.79% ± 9%, p = 0.001), compared with those in the placebo group (13.35% ± 7.1% vs. 13.43% ± 7.8%, p = 0.38). There were no significant differences in MACE between both groups.
CONCLUSIONS: Levosimendan is a safe and effective therapeutic option for reducing infarct size in patients with STEMI.
METHODS: Patients were randomized to receive a 24-h infusion of either levosimendan (0.1 μg/kg/min) or placebo after the primary angioplasty. The main objective was to assess the size of the infarct by cardiac resonance at 30 days and 6 months after the event. Other variables such as left ventricular ejection fraction (LVEF) and adverse ventricular remodeling (AVR) were assessed by speckle-tracking echocardiography and magnetic resonance. Major adverse cardiovascular events (MACE) were also collected.
RESULTS: 157 patients were analysed (levosimendan, n = 79; placebo, n = 78). We found that after 6 months, patients treated with levosimendan had a greater reduction in infarct size (13.19% ± 9.5% vs.11.79% ± 9%, p = 0.001), compared with those in the placebo group (13.35% ± 7.1% vs. 13.43% ± 7.8%, p = 0.38). There were no significant differences in MACE between both groups.
CONCLUSIONS: Levosimendan is a safe and effective therapeutic option for reducing infarct size in patients with STEMI.
Предметные рубрики MeSH
AgedFemaleHumansMaleMiddle AgedCardiotonic AgentsDouble-Blind MethodInfusions, IntravenousMyocardiumPercutaneous Coronary InterventionProspective StudiesPyridazinesRecovery of FunctionSimendanST Elevation Myocardial InfarctionStroke VolumeTime FactorsTreatment OutcomeVentricular Function, LeftVentricular Remodeling