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Cardiogenic shock after primary percutaneous coronary intervention: Effects of levosimendan compared with dobutamine on haemodynamics
Author(s) -
GarcíaGonzález Martín J.,
DomínguezRodríguez Alberto,
FerrerHita Julio J.,
AbreuGonzález Pedro,
Muñoz Miguel Bethencourt
Publication year - 2006
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2006.01.007
Subject(s) - levosimendan , dobutamine , medicine , cardiogenic shock , cardiology , hemodynamics , myocardial infarction , inotrope , conventional pci , percutaneous coronary intervention , shock (circulatory) , anesthesia
Background: Levosimendan is a new calcium sensitizer with positive inotropic properties. Cardiac power output (CPO) has been shown to be instrumental in the diagnosis of cardiogenic shock (CS) and is an important determinant of outcomes. Aims: To evaluate the haemodynamic effects of levosimendan compared to dobutamine in acute myocardial infarction (AMI) patients revascularised by primary percutaneous coronary intervention (PCI), who developed CS. Methods and results: Twenty two consecutive AMI patients revascularised by PCI, who developed CS, were randomly assigned to levosimendan (24μg kg −1 bolus plus 24‐h continuous infusion 0,1μg kg −1 min −1 ) or dobutamine (initial dose 5μg kg −1 min −1 , with a maximum dose adjustment in order to reach the desired haemodynamic effect). Evaluations were performed from baseline to 30h. The primary end‐point was an increase ≥30% in CPO, after 24h of therapy. The baseline clinical and haemodynamic characteristics were similar in both groups. Levosimendan had a consistently better effect on CPO than dobutamine, while the decrease in PCWP was similar. Conclusion: The primary objective of our study was achieved better by the end of the 24h infusion of levosimendan than by dobutamine.