Can Levosimendan Help to Prevent Low Cardiac Output Syndrome?

Despite earlier promising evidence, a randomized trial shows no benefit of perioperative levosimendan for high-risk cardiac-surgery patients.

Low cardiac output syndrome after cardiac surgery is associated with poor outcomes. Prior small trials have suggested that the inotrope and calcium sensitizer levosimendan, which has not been FDA-approved, may be beneficial. In a manufacturer-sponsored trial (NCT02025621), 882 patients (median age, 65; 20% women) with left ventricular ejection fraction (LVEF) ≤35%, who were scheduled to undergo cardiac surgery with cardiopulmonary bypass, were randomized to receive levosimendan or placebo. Administration started preoperatively and continued for 24 hours.

The primary combined endpoint (death within 30 days; renal replacement therapy within 30 days; perioperative myocardial infarction within 5 days; or use of mechanical cardiac assist device w…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)