Efficacy and safety of levosimendan in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: The LEVOCEST trial.

Autor: Bosa Ojeda F; Department of Interventional Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain.; Department of Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Méndez Vargas C; Department of Interventional Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain.; Department of Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Lacalzada Almeida J; Department of Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Izquierdo Gómez MM; Department of Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Jiménez Sosa A; Research Unit, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Rodríguez Jiménez C; Clinical Pharmacology Service, Clinical Research and Clinical Trials Unit of the University Hospital of the Canary Islands, Canary Islands, Spain., Sánchez-Grande Flecha A; Department of Interventional Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain.; Department of Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Bosa Santana M; Emergency Department, University Hospital Nuestra Señora de Candelaria, Canary Islands, Spain., Yanes Bowden G; Department of Interventional Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain.; Department of Cardiology, University Hospital of the Canary Islands, La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2024 Dec; Vol. 104 (7), pp. 1414-1422. Date of Electronic Publication: 2024 Oct 19.
DOI: 10.1002/ccd.31267
Abstrakt: 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.
(© 2024 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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