SynthesisEuropean journal of clinical pharmacology2026
Levosimendan vs. Milrinone in cardiac surgery: A GRADE-assessed systematic review and meta-analysis.
Synthesis in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Screening rates and geographical disparities shape venous thromboembolism risk after cardiac surgery: a systematic review and meta-analysis.Journal of cardiothoracic surgery · 2026Pooled it
- Early use of levosimendan to improve survival and neurological outcomes after cardiac arrest with myocardial dysfunction: a protocol for a randomized controlled trial.Frontiers in cardiovascular medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLevosimendan and Milrinone are commonly used inotropic agents in patients undergoing cardiac surgery; there is a lack of evidence regarding the comparative safety and efficacy of both drugs. We aim to compare the clinical efficacy and safety of levosimendan versus Milrinone in these patients.
methodsWe conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, Scopus, Web of Science, and Cochrane Central were searched up to November 30, 2024, for studies comparing levosimendan and Milrinone in adult and pediatric cardiac surgery patients. We used R statistical software to pool dichotomous data using odds ratio (OR) and continuous data using mean difference (MD) with a 95% confidence interval (CI).
resultsSeventeen studies (15 RCTs and 2 observational) involving 890 patients were included. Across all efficacy outcomes, including cardiac index (MD 0.02, 95% CI -0.15-0.19), mean arterial pressure (MAP) (MD -0.09, 95% CI -1.97-1.79), and mPAP (mean pulmonary artery pressure) (MD -0.88, 95% CI -2.66, 0.89), no significant differences were found between the two drugs (P > 0.05). Safety outcomes, including all-cause mortality (OR 0.97, 95% CI 0.48-1.93), acute kidney injury (OR 0.89, 95% CI 0.55-1.44), and arrhythmias (OR 0.87, 95% CI 0.41-1.88), showed no statistically significant differences (P > 0.05).
conclusionLevosimendan and Milrinone showed no significant differences in efficacy or safety in cardiac surgery patients. However, wide confidence intervals indicate potential clinically relevant effects. Current evidence does not favor any single agent universally, supporting individualized use based on patient phenotype and institutional practice. Further high-quality trials are needed to confirm.
Indexed as
Identifiers
41546720What OpenQuestion holds
Registered trials
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.