dr. miguel gonzalez, mtsac, facc/media/non-clinical/files-pdfs... · dr. miguel gonzalez, mtsac,...
TRANSCRIPT
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Dr. Miguel Gonzalez, MTSAC, FACC
Chief Coronary Care Unit – Sanatorio Finochietto - Argentina
President Argentine Society of Cardiology
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Background
Levosimendan is not approved by FDA
Levosimenda
n
Dobutamin
e
HR
(95% CI)
p
value
28% 15% 1.9 (1.1-3.3)
0.022
26% 38% 0.57 (0.34-0.95)
0.029
Hemodynamic effects and mortality rates of levosimendan vs dobutamine
Follath F et al. Lancet 2002, julio 20
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Background
Harrison RW et al . J Cardiothorac Vasc Anesth 2013; 14
Ju Yong Lim et al . J Card Surg 2015; 30
Early Mortality
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Multicenter, Prospective, Randomized, Double blind, Placebo controlled
Design
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Header
Mehta RH et al. N Engl J Med 2017; 376
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Mehta RH et al. N Engl J Med 2017; 376
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Low CardiacOutput
Syndrome
SecondaryInotrope Use
> 24 hs
Mehta RH et al. N Engl J Med 2017; 376
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Conclusions
Levosimendan,
given Prophylactically prior to cardiac surgery to patients with reduced left ventricular functionHad no effect on the co-primary outcomes of:
• Death, Dialysis, MI or mechanical assist device use• Death or mechanical assist device use
As an inotrope was effective and safe to increase cardiac output
Mehta RH et al. N Engl J Med 2017; 376
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Mehta RH et al. N Engl J Med 2017; 376