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

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions Pub Date : 2024-10-19 DOI:10.1002/ccd.31267

Francisco Bosa Ojeda MD, PhD, Corabel Méndez Vargas MD, Juan Lacalzada Almeida MD, PhD, María M. Izquierdo Gómez MD, PhD, Alejandro Jiménez Sosa PhD, Consuelo Rodríguez Jiménez MD, PhD, Alejandro Sánchez-Grande Flecha MD, PhD, Marta Bosa Santana MD, Geoffrey Yanes Bowden MD, PhD

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引用次数: 0

Abstract

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.

Abstract Image

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左西孟旦对接受经皮冠状动脉介入治疗的 ST 段抬高型心肌梗死患者的疗效和安全性：LEVOCEST试验。

背景：初级血管成形术是 ST 段抬高型心肌梗死（STEMI）患者的标准手术。然而，心肌再灌注会造成额外的细胞损伤。左西孟旦具有多种效应，可能是防止这种损伤的替代治疗方法。本研究的目的是评估这种药物能否缩小 STEMI 患者的梗死面积：方法：患者被随机分配到接受一次血管成形术后 24 小时输注左西孟旦（0.1 μg/kg/min）或安慰剂。主要目的是在事件发生 30 天和 6 个月后通过心脏共振评估梗塞的大小。其他变量如左室射血分数（LVEF）和不良心室重构（AVR）则通过斑点追踪超声心动图和磁共振进行评估。此外，还收集了主要心血管不良事件（MACE）：分析了 157 名患者（左西孟丹，79 人；安慰剂，78 人）。我们发现，6个月后，与安慰剂组（13.35% ± 7.1% vs. 13.43% ± 7.8%，p = 0.38）相比，接受左西孟旦治疗的患者梗死面积缩小幅度更大（13.19% ± 9.5% vs. 11.79% ± 9%，p = 0.001）。两组患者的MACE无明显差异：结论：左西孟丹是缩小 STEMI 患者梗死面积的一种安全有效的治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.