Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry

Aim: Patients with advanced heart failure (AHF) who are not candidates to advanced therapies have poor prognosis. Some trials have shown that intermittent levosimendan can reduce HF hospitalizations in AHF in the short term. In this real-life registry, we describe the patterns of use, safety and fac...

ver descrição completa

Detalhes bibliográficos
Autores: Dobarro Pérez, David, Donoso Trenado, Víctor, Solé González, Eduard, Moliner Abós, Carlos, García Pinilla, José Manuel, López Fernández, Silvia, Ruiz Bustillo, Sonia, Díez López, Carles, Juan Bagudá, Javier de, González Costello, José, Et al.
Tipo de documento: artigo
Data de publicação:2023
País:España
Recursos:Universidad Europea (UEM)
Repositório:ABACUS. Repositorio de Producción Científica
Idioma:inglês
OAI Identifier:oai:abacus.universidadeuropea.com:11268/12407
Acesso em linha:http://hdl.handle.net/11268/12407
Access Level:Acceso aberto
Palavra-chave:Simendán
Cuidados paliativos
Insuficiencia cardíaca
Enfermedad cardiovascular
Tratamiento médico
Medicamento
id ES_43ba25678dc271f7cc0d8ea315e6253f
oai_identifier_str oai:abacus.universidadeuropea.com:11268/12407
network_acronym_str ES
network_name_str España
repository_id_str
spelling Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registryDobarro Pérez, DavidDonoso Trenado, VíctorSolé González, EduardMoliner Abós, CarlosGarcía Pinilla, José ManuelLópez Fernández, SilviaRuiz Bustillo, SoniaDíez López, CarlesJuan Bagudá, Javier deGonzález Costello, JoséEt al.SimendánCuidados paliativosInsuficiencia cardíacaEnfermedad cardiovascularTratamiento médicoMedicamentoAim: Patients with advanced heart failure (AHF) who are not candidates to advanced therapies have poor prognosis. Some trials have shown that intermittent levosimendan can reduce HF hospitalizations in AHF in the short term. In this real-life registry, we describe the patterns of use, safety and factors related to the response to intermittent levosimendan infusions in AHF patients not candidates to advanced therapies. Methods and results: Multicentre retrospective study of patients diagnosed with advanced heart failure, not HT or LVAD candidates. Patients needed to be on the optimal medical therapy according to their treating physician. Patients with de novo heart failure or who underwent any procedure that could improve prognosis were not included in the registry. Four hundred three patients were included; 77.9% needed at least one admission the year before levosimendan was first administered because of heart failure. Death rate at 1 year was 26.8% and median survival was 24.7 [95% CI: 20.4-26.9] months, and 43.7% of patients fulfilled the criteria for being considered a responder lo levosimendan (no death, heart failure admission or unplanned HF visit at 1 year after first levosimendan administration). Compared with the year before there was a significant reduction in HF admissions (38.7% vs. 77.9%; P < 0.0001), unplanned HF visits (22.7% vs. 43.7%; P < 0.0001) or the combined event including deaths (56.3% vs. 81.4%; P < 0.0001) during the year after. We created a score that helps predicting the responder status at 1 year after levosimendan, resulting in a score summatory of five variables: TEER (+2), treatment with beta-blockers (+1.5), Haemoglobin >12 g/dL (+1.5), amiodarone use (-1.5) HF visit 1 year before levosimendan (-1.5) and heart rate >70 b.p.m. (-2). Patients with a score less than -1 had a very low probability of response (21.5% free of death or HF event at 1 year) meanwhile those with a score over 1.5 had the better chance of response (68.4% free of death or HF event at 1 year). LEVO-D score performed well in the ROC analysis. Conclusion: In this large real-life series of AHF patients treated with levosimendan as destination therapy, we show a significant decrease of heart failure events during the year after the first administration. The simple LEVO-D Score could be of help when deciding about futile therapy in this population.20232023-11-3020232023-01-0120232023-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/11268/12407reponame:ABACUS. Repositorio de Producción Científicainstname:Universidad Europea (UEM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución-NoComercial 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:abacus.universidadeuropea.com:11268/124072026-06-11T12:41:27Z
dc.title.none.fl_str_mv Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry
title Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry
spellingShingle Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry
Dobarro Pérez, David
Simendán
Cuidados paliativos
Insuficiencia cardíaca
Enfermedad cardiovascular
Tratamiento médico
Medicamento
title_short Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry
title_full Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry
title_fullStr Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry
title_full_unstemmed Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry
title_sort Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry
dc.creator.none.fl_str_mv Dobarro Pérez, David
Donoso Trenado, Víctor
Solé González, Eduard
Moliner Abós, Carlos
García Pinilla, José Manuel
López Fernández, Silvia
Ruiz Bustillo, Sonia
Díez López, Carles
Juan Bagudá, Javier de
González Costello, José
Et al.
author Dobarro Pérez, David
author_facet Dobarro Pérez, David
Donoso Trenado, Víctor
Solé González, Eduard
Moliner Abós, Carlos
García Pinilla, José Manuel
López Fernández, Silvia
Ruiz Bustillo, Sonia
Díez López, Carles
Juan Bagudá, Javier de
González Costello, José
Et al.
author_role author
author2 Donoso Trenado, Víctor
Solé González, Eduard
Moliner Abós, Carlos
García Pinilla, José Manuel
López Fernández, Silvia
Ruiz Bustillo, Sonia
Díez López, Carles
Juan Bagudá, Javier de
González Costello, José
Et al.
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Simendán
Cuidados paliativos
Insuficiencia cardíaca
Enfermedad cardiovascular
Tratamiento médico
Medicamento
topic Simendán
Cuidados paliativos
Insuficiencia cardíaca
Enfermedad cardiovascular
Tratamiento médico
Medicamento
description Aim: Patients with advanced heart failure (AHF) who are not candidates to advanced therapies have poor prognosis. Some trials have shown that intermittent levosimendan can reduce HF hospitalizations in AHF in the short term. In this real-life registry, we describe the patterns of use, safety and factors related to the response to intermittent levosimendan infusions in AHF patients not candidates to advanced therapies. Methods and results: Multicentre retrospective study of patients diagnosed with advanced heart failure, not HT or LVAD candidates. Patients needed to be on the optimal medical therapy according to their treating physician. Patients with de novo heart failure or who underwent any procedure that could improve prognosis were not included in the registry. Four hundred three patients were included; 77.9% needed at least one admission the year before levosimendan was first administered because of heart failure. Death rate at 1 year was 26.8% and median survival was 24.7 [95% CI: 20.4-26.9] months, and 43.7% of patients fulfilled the criteria for being considered a responder lo levosimendan (no death, heart failure admission or unplanned HF visit at 1 year after first levosimendan administration). Compared with the year before there was a significant reduction in HF admissions (38.7% vs. 77.9%; P < 0.0001), unplanned HF visits (22.7% vs. 43.7%; P < 0.0001) or the combined event including deaths (56.3% vs. 81.4%; P < 0.0001) during the year after. We created a score that helps predicting the responder status at 1 year after levosimendan, resulting in a score summatory of five variables: TEER (+2), treatment with beta-blockers (+1.5), Haemoglobin >12 g/dL (+1.5), amiodarone use (-1.5) HF visit 1 year before levosimendan (-1.5) and heart rate >70 b.p.m. (-2). Patients with a score less than -1 had a very low probability of response (21.5% free of death or HF event at 1 year) meanwhile those with a score over 1.5 had the better chance of response (68.4% free of death or HF event at 1 year). LEVO-D score performed well in the ROC analysis. Conclusion: In this large real-life series of AHF patients treated with levosimendan as destination therapy, we show a significant decrease of heart failure events during the year after the first administration. The simple LEVO-D Score could be of help when deciding about futile therapy in this population.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-11-30
2023
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/11268/12407
url http://hdl.handle.net/11268/12407
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución-NoComercial 4.0 Internacional
http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución-NoComercial 4.0 Internacional
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:ABACUS. Repositorio de Producción Científica
instname:Universidad Europea (UEM)
instname_str Universidad Europea (UEM)
reponame_str ABACUS. Repositorio de Producción Científica
collection ABACUS. Repositorio de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869407044038033408
score 15,198674

Registros relacionados