Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty

Abstract

Background: Cardiogenic shock (CS) after ST elevation myocardial infarction (STEMI) worsens patient's outcome. Levosimendan treatment offers short-term survival benefit in acute heart failure but its effect on long-term outcome remains unclear. We sought to assess the effect on long-term survival of levosimendan compared to dobutamine treatment in patients with STEMI revascularized by primary coronary angioplasty (PCI) who subsequently developed CS.

Methods and results: Twenty-two consecutive STEMI patients with CS after PCI randomized to receive levosimendan or dobutamine treatment for 24 h were followed-up for twelve months. Complete follow-up was obtained in 100% of them. The endpoint was cardiac death. Baseline clinical and haemodynamic characteristics were similar in both groups. The probability of survival calculated with Kaplan-Meier curves analysis showed no statistically significant differences between both groups (p=0.24).

Conclusions: Levosimendan compared to dobutamine did not improve long-term survival in STEMI patients revascularized by PCI who developed CS.