Turkiewicz Karol, Kulczycki Jan Jakub, Rola Piotr, Włodarczak Szymon, Barycki Mateusz, Włodarczak Piotr, Furtan Łukasz, Kozak Paweł, Doroszko Adrian, Banasiak Waldemar, Lesiak Maciej, Włodarczak Adrian
Department of Cardiology, The Copper Health Centre (MCZ), 59-301 Lubin, Poland.
Faculty of Medicine, Wroclaw University of Science and Technology, 50-981 Wroclaw, Poland.
J Clin Med. 2025 Apr 17;14(8):2761. doi: 10.3390/jcm14082761.
Current evidence suggests that levosimendan may have a beneficial effect in the treatment of acute heart failure (AHF) or cardiogenic shock following primary percutaneous coronary intervention (PCI). However, there is a paucity of data on the use of levosimendan prior to PCI. Therefore, our pilot study aimed to assess the short-term prognosis of a new therapeutic protocol involving preprocedural infusion of levosimendan in patients with reduced left ventricular ejection fraction undergoing high-risk PCI for acute coronary syndrome (ACS). The study is a retrospective observational study, and the population includes all subjects who received levosimendan infusion prior to high-risk PCI for ACS. Subjects requiring urgent revascularization (cardiogenic shock, cardiac arrest) or with mechanical complications of ACS were excluded. The study cohort consisted of 90 subjects, predominantly men (91.1%) with significantly reduced left ventricular function (28.7% (12)) and advanced coronary artery disease, mean SYNTAX Score 25.8 (19.3-33). During in-hospital follow-up, we observed 2 primary outcomes-death. The major adverse cardiac and cerebrovascular events (MACCE) rate was 7.8%. Two clinical adverse events that did not lead to discontinuation were observed during the in-hospital period. Both were related to hypotension. In short-term observation, novel therapeutic approach in the management of high-risk PCI in ACS patients-pre-procedural levosimendan-was a relatively safe approach. No significant adverse events were reported.
目前的证据表明，左西孟旦在治疗急性心力衰竭（AHF）或原发性经皮冠状动脉介入治疗（PCI）后的心源性休克方面可能具有有益作用。然而，关于PCI术前使用左西孟旦的数据较少。因此，我们的初步研究旨在评估一种新治疗方案的短期预后，该方案涉及在因急性冠状动脉综合征（ACS）接受高危PCI的左心室射血分数降低的患者中术前输注左西孟旦。该研究是一项回顾性观察研究，研究对象包括所有在因ACS接受高危PCI术前接受左西孟旦输注的受试者。需要紧急血运重建（心源性休克、心脏骤停）或有ACS机械并发症的受试者被排除在外。研究队列由90名受试者组成，主要为男性（91.1%），左心室功能显著降低（28.7%（12））且患有晚期冠状动脉疾病，平均SYNTAX评分为25.8（19.3 - 33）。在住院随访期间，我们观察到2个主要结局——死亡。主要不良心脑血管事件（MACCE）发生率为7.8%。住院期间观察到2例未导致停药的临床不良事件。两者均与低血压有关。在短期观察中，ACS患者高危PCI管理中的新治疗方法——术前使用左西孟旦——是一种相对安全的方法。未报告重大不良事件。
