SynthesisBioMed research international2018
Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery: An Update Meta-Analysis and Trial Sequential Analysis.
Synthesis in BioMed research international, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Levosimendan vs. Intra-Aortic Balloon Pump in Coronary Artery Bypass Grafting: A Meta-Analysis.Brazilian journal of cardiovascular surgery · 2026Pooled it
- Prophylactic use of inotropic agents for the prevention of low cardiac output syndrome and mortality in adults undergoing cardiac surgery.The Cochrane database of systematic reviews · 2024Pooled it
- Levosimendan and systemic vascular resistance in cardiac surgery patients: a systematic review and meta-analysis.Scientific reports · 2019Pooled it
- Kidney Injury Following Cardiac Surgery: A Review of Our Current Understanding.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025Review
- The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery.Journal of cardiovascular development and disease · 2023Article
- Preoperative Levosimendan therapy reduces postoperative right ventricular failure in patients undergoing left ventricular assist device implantation.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Levosimendan improves postoperative heart function recovery and prognosis in patients with heart disease.American journal of translational research · 2022Article
- Preconditioning with levosimendan reduces postoperative low cardiac output in moderate-severe systolic dysfunction patients who will undergo elective coronary artery bypass graft surgery: a cost-effective strategy.Journal of cardiothoracic surgery · 2020Article
- Levosimendan for patients with heart failure undergoing major oncological surgery: A randomised blinded pilot study.Indian journal of anaesthesia · 2019Article
- New-Onset Atrial Fibrillation in Adult Patients After Cardiac Surgery.Current anesthesiology reports · 2019Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent studies suggest that levosimendan does not provide mortality benefit in patients with low cardiac output syndrome undergoing cardiac surgery. These results conflict with previous findings. The aim of the current study is to assess whether levosimendan reduces postoperative mortality in patients with impaired left ventricular function (mean EF ≤ 40%) undergoing cardiac surgery.
methodsWe conducted a comprehensive search of PubMed, EMBASE, and Cochrane Library Database through November 20, 2017. Inclusion criteria were random allocation to treatment with at least one group receiving levosimendan and another group receiving placebo or other treatments and cardiac surgery patients with a left ventricular ejection fraction of 40% or less. The primary endpoint was postoperative mortality. Secondary outcomes were cardiac index, pulmonary capillary wedge pressure (PCWP), length of intensive care unit (ICU) stay, postoperative atrial fibrillation, and postoperative renal replacement therapy. We performed trial sequential analysis (TSA) to evaluate the reliability of the primary endpoint.
resultsData from 2,152 patients in 15 randomized clinical trials were analyzed. Pooled results demonstrated a reduction in postoperative mortality in the levosimendan group [RR = 0.53, 95% CI (0.38-0.73),
conclusionsLevosimendan reduces the rate of death and other adverse outcomes in patients with low ejection fraction who were undergoing cardiac surgery, but results remain inconclusive. More large-volume randomized clinical trials (RCTs) are warranted.
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