Effectiveness and safety of levosimendan in clinical practice [13]

José Silva-Cardoso, Jorge Ferreira, Ana Oliveira-Soares, José Martins-de-Campos, Cândida Fonseca, Nuno Lousada, José Ilídio-Moreira, Carlos Rabaçal, Albertino Damasceno, Sandra Amorim, Ricardo Seabra-Gomes, Rafael Ferreira, Cassiano Abreu-Lima

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21 Citations (Scopus)


Background: In previous randomized studies levosimendan improved hemodynamics and clinical course, with a still unclear effect on prognosis. There are, however, few data regarding its effects when used in daily practice. Aims: We evaluated the clinical effectiveness and safety of levosimendan in the treatment of acute systolic heart failure (SHF) in daily practice conditions. Methods: In this prospective, multicenter, nonrandomized trial, a continuous infusion of levosimendan (0.05 μg/kg/min-0.2 μg/kg/min) was administered for 24 hours. An optional loading dose of 12 μg/kg over 10 minutes was used. The primary combined endpoint of clinical effectiveness (as defined by a eight- variable clinical score) and safety (defined by the absence of serious adverse events) was assessed at 24 hours after the beginning of treatment; a second similar primary combined endpoint was assessed at 5 days. Results: One hundred and twenty-nine consecutive patients requiring inotropes despite optimal oral background heart failure therapy were recruited. The primary end point was reached in 80.6% at 24 hours and in 79.7% at 5 days. During the six months before levosimendan the number of patient days of hospitalization for heart failure was 14.9±14.6 versus 3.1±7.6 during the six months following levosimendan (p<0.001). Conclusions: In daily practice, levosimendan was clinically effective and safe in 80.6% and 79.7% of patients with acute SHF at 24 hours and 5 days respectively after the beginning of treatment. A marked reduction in the number of days of hospitalization for heart failure was also seen during the subsequent six months.

Original languageEnglish
Pages (from-to)143-154
Number of pages12
JournalRevista Portuguesa de Cardiologia
Issue number2
Publication statusPublished - 1 Feb 2009


  • Acute heart failure
  • Levosimendan
  • notropes


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