Perioperative administration of enoximone and renal function after cardiac surgery: a propensity-matched analysis

Preliminary results of the Multicenter Observational Study with Enoximone in Cardiac surgery (MOSEC)

BACKGROUND

Perioperative administration of Enoximone has been shown to improve hemodynamics, organ function, and inflammatory response. Aim of the present study was to evaluate the effects of Enoximone after on-pump cardiac surgery.

METHODS

A protocol for a multicenter observational study was reviewed and approved by local ethic committee. This preliminary report involves the first 29 patients enrolled, in whom Enoximone was perioperatively administered in the context of on-pump cardiac surgery. All patients enrolled were propensity-matched 1:1 with controls not receiving Enoximone, renal function was evaluated in terms of estimated glomerular filtration rate (eGFR) with the CKD-EPI equation.

RESULTS

After propensity matching, the two cohorts of patients receiving Enoximone or not did not show any significant differences among baseline characteristics. Patients receiving Enoximone showed a progressive improvement of eGFR at each time-point of follow-up: roughly +4.3, +10.0, and +12.3 mL/min/1.73 m² on postoperative days 2, 7, and 30; respectively. Consistently, maximum difference versus baseline was +12.6 mL/min/1.73 m² (or +19.3%) among Enoximone patients vs +3.3 mL/min/1.73 m² (or +4.4%) among controls (p = 0.02). Multivariable regression analysis (R²-adjusted 0.47) showed only age (β -0.53; p = 0.01), preoperative eGFR (β -0.39; p = 0.02), diabetes (β 2.1; p = 0.01), cardio-pulmonary bypass duration (β 0.08; p = 0.05), and Enoximone administration (β -0.74; p = 0.05) to be independently correlated with delta eGFR variation on day 30.

CONCLUSION

These preliminary results show that perioperative Enoximone administration improved renal function in patients undergoing on-pump cardiac surgery. Further studies are needed to confirm these findings.