Effect of levosimendan on long-term prognosis in patients with myocardial infarction and concomitant chronic brain ischemia

Abstract

Aim. To study the effect of levosimendan (LS) on 1-year prognosis in patients with myocardial infarction (MI), complicated with heart failure (HF), and concomitant chronic brain ischemia (CBI).Material and methods. The study included 182 patients with Q-wave MI, complicated by HF with left ventricular ejection fraction (LVEF)<40%, and concomitant CBI (149 (81,9%) men and 33 (18,1%) women). The median age was 60,4 (53; 69) years. Group I (control) included 49 patients who received standard therapy; group II (experimental) — 133 patients who were injected with LS on days 1-2 of MI. All patients underwent echocardiography, duplex ultrasound of peripheral arteries and were examined by angioneurologist. A year later, the hard endpoints of recurrent MI, angina progression, revascularization, acute decompensated HF, rehospitalizations, strokes, and death were assessed.Results. According to multivariate regression analysis, LS administered in the acute period of myocardial infarction reduced the risk of hard endpoints (hazard ratio, 0,32,95% confidence interval, 0,2-0,52, p=0,001), but did not affect patient survival.Conclusion. In patients with MI complicated by left ventricular failure and associated with CBI, LS infusion in the acute period of MI can reduce the risk of adverse cardiovascular events during the year.

Keywords

• myocardial infarction
• chronic brain ischemia
• heart failure
• levosi-mendan
• prognosis