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Tumminello G, Cereda A, Barbieri L, Biondi-Zoccai G, Lucreziotti S, Mafrici A, Carugo S. Meta-Analysis of Placebo-Controlled Trials of Levosimendan in Acute Myocardial Infarction. J Cardiovasc Dev Dis 2021; 8:129. [PMID: 34677198 PMCID: PMC8539734 DOI: 10.3390/jcdd8100129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 02/05/2023] Open
Abstract
The treatment of acute myocardial infarction is early revascularization. Heart failure and cardiogenic shock may complicate acute myocardial infarction despite applying the best available strategy. Levosimendan is a relatively new drug to treat heart failure with a peculiar mechanism of action: calcium sensitization of myocardial fibres. Levosimendan has a direct inotropic effect but also pleiotropic effects; through the K+ATP channel's opening, it also has a vasodilator effect which may participate concretely in the global effects of the drug. The focus of the literature is on the anti-heart failure and anti-cardiogenic shock properties of Levosimendan, but it may have effects also preventing the development of myocardial insufficiency in acute myocardial infarction. The aim of the meta-analysis is to evaluate the effect of Levosimendan on acute myocardial infarction in placebo-controlled trials. Based on the eight studies selected, we found a beneficial effect of Levosimendan on acute and long-term mortality of patients affected by acute myocardial infarction. With caution in interpreting the results of this meta-analysis, our data support the idea that Levosimendan may already have a role in the treatment of acute ischemic heart disease. Further studies specifically designed to investigate the early role in the treatment of ischemic heart failure are needed.
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Affiliation(s)
- Gabriele Tumminello
- Cardiology Division, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.C.); (S.L.); (A.M.)
| | - Alberto Cereda
- Cardiology Division, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.C.); (S.L.); (A.M.)
| | - Lucia Barbieri
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Division of Cardiology, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (L.B.); (S.C.)
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy;
- Mediterranea Cardiocentro, 80138 Napoli, Italy
| | - Stefano Lucreziotti
- Cardiology Division, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.C.); (S.L.); (A.M.)
| | - Antonio Mafrici
- Cardiology Division, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.C.); (S.L.); (A.M.)
| | - Stefano Carugo
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Division of Cardiology, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (L.B.); (S.C.)
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