Evidence map›Paper›PMID 33127531›Full record

Trial reportAmerican heart journal2021

Association between levosimendan, postoperative AKI, and mortality in cardiac surgery: Insights from the LEVO-CTS trial.

Oliver K Jawitz, Amanda S Stebbins, Vignesh Raman, Brooke Alhanti, Sean van Diepen, Matthias Heringlake, Stephen Fremes, Richard Whitlock, Steven R Meyer, Rajendra H Mehta and 4 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.1field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. ISCCM Guidelines on Acute Kidney Injury and Renal Replacement Therapy.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022
    Article
  6. Review
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 3 countries.

Oliver K JawitzDepartment of Surgery, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. Electronic address: oliver.jawitz@duke.edu.
Amanda S StebbinsDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Vignesh RamanDepartment of Surgery, Duke University Medical Center, Durham, NC.
Brooke AlhantiDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Sean van DiepenDepartment of Critical Care and Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada; Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
Matthias HeringlakeDepartment of Anesthesia, University of Lübeck, Lübeck, Germany.
Stephen FremesDepartment of Surgery, University of Toronto, Toronto, Ontario, Canada.
Richard WhitlockDepartment of Surgery, McMaster University, Hamilton, Ontario, Canada.
Steven R MeyerMazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
Rajendra H MehtaDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Mark Stafford-SmithDepartment of Anesthesiology, Duke University Medical Center, Durham, NC.
Shaun G GoodmanDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada; St. Michael's Hospital, University of Toronto, Ontario, Canada.
John H AlexanderDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Renato D LopesDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Clinical Research Institute · USDuke Medical Center · USUniversity of Alberta · CAMcMaster University · CASt. Michael's Hospital · CAUniversity of Lübeck · DEUniversity of Toronto · CA

Funding

Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
NHLBI NIH HHS T32 HL069749
6 · The paper itself

Abstract

objectivesWe aimed to evaluate the association between levosimendan treatment and acute kidney injury (AKI) as well as assess the clinical sequelae of AKI in cardiac surgery patients with depressed left ventricular function (ejection fraction <35%).

methodsPatients in the LEVO-CTS trial undergoing on-pump coronary artery bypass grafting (CABG), valve, or CABG/valve surgery were stratified by occurrence and severity of postoperative AKI using the AKIN classification. The association between levosimendan infusion and AKI was modeled using multivariable regression.

resultsAmong 854 LEVO-CTS patients, 231 (27.0%) experienced postoperative AKI, including 182 (21.3%) with stage 1, 35 (4.1%) with stage 2, and 14 (1.6%) with stage 3 AKI. The rate of AKI was similar between patients receiving levosimendan or placebo. The odds of 30-day mortality significantly increased by AKI stage compared to those without AKI (stage 1: adjusted odds ratio [aOR] 2.0, 95% confidence interval [CI] 0.8-4.9; stage 2: aOR 9.1, 95% CI 3.2-25.7; stage 3: aOR 12.4, 95% CI 3.0-50.4). No association was observed between levosimendan, AKI stage, and odds of 30-day mortality (interaction P = .69). Factors independently associated with AKI included increasing age, body mass index, diabetes, and increasing baseline systolic blood pressure. Increasing baseline eGFR and aldosterone antagonist use were associated with a lower risk of AKI.

conclusionsPostoperative AKI is common among high-risk patients undergoing cardiac surgery and associated with significantly increased risk of 30-day death or dialysis. Levosimendan was not associated with the risk of AKI.

Indexed as

Acute Kidney InjuryAgedCardiac Surgical ProceduresCardiotonic AgentsCoronary Artery BypassFemaleHumansMaleMiddle AgedOdds RatioPlacebosPostoperative ComplicationsRegression AnalysisRisk FactorsSimendanStroke VolumeCardiotonic AgentsPlacebosSimendan

Identifiers

PMID33127531
PMCPMC7755750
OpenAlexW3096830564

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.