Effect of levosimendan in the treatment of heart failure in patients with acute myocardial infarction / 中国基层医药

ABSTRACT

Objective To evaluate the efficacy and safety of levosimendan applied in patients with chronic heart failure combined with acute ST -elevation myocardium after direct percutaneous coronary intervention (PCI). Methods Using the random number table method,95 patients with heart failure combined with acute ST -elevation myocardium after direct PCI were randomly divided into two groupsthe general treatment group and the levosimendan group.The levels of serum NT -proBNP,LVSD,LVEF before and after 24h,one week treatment were examined.After the experiment,clinical assessment was performed to evaluate the efficacy and safety of levosimendan.Results The resuits of NT -proBNP,LVEF and LVSD in the general group before treatment were (5 908.1 ±33.2)ng/L, (36.7 ±4.3)% and (6.1 ±0.6)cm,while those were (3 478.5 ±19.3)ng/L,(45.0 ±6.3)%,(5.9 ±0.3)cm, (3 375.2 ±32.1)ng/L,(48.3 ±5.4)% and (5.8 ±1.1)cm after 24h and 1 week treatment.The level of serum NT-proBNP decreased,while the LVEF increased in general treatment group after 24h treatment(t =3.86,4.11,P =0.021,0.015).The same results happened after 1 week treatment(compared with before treatment,t =4.13,5.06, P =0.016,0.013,compared with 24 hours after treatment,t =3.96,4.77,P =0.021,0.015).But the level of the LVSD had no differences before and after 24h,1 week treatment(P >0.05).The results of NT -proBNP,LVEF and LVSD in the levosimendan group before treatment were (3 340.5 ±19.2)ng/L,(43.3 ±3.9)%,(5.3 ±0.7)cm, (2 938.3 ±12.8)ng/L,(52.7 ±8.2)% and (4.6 ±0.2)cm after 24h and 1 week treatment.The levels of serum NT -proBNP,LVSD decreased,while the LVEF increased in the levosimendan group after 24h,1 week treatment(t =6.07,6.49,5.73,P =0.010,0.008,0.011.t =6.55,7.05,5.33,P =0.009,0.007,0.012).Compared with the general treatment group,the levels of serum NT -proBNP,LVEF showed no differences(all P >0.05),but the level of the LVSD decreased after 24h treatment(t =4.84,P =0.015)in the levosimendan group.The levels of serum NT -proBNP,LVSD decreased,while the LVEF increased in the levosimendan group after 1 week treatment compared with the general treatment group(t =6.60,7.01,5.40,P =0.007,0.007,0.011 ).After one week treatment,the effective and beneficial rates of the levosimendan group were 66.6% and 95.6%,while those were 59.6% and 89.5% in the general treatment group.The therapeutic effects of levosimendan group were more effective than the general treatment group after 1 week treatment(χ2 =9.72,15.63,P =0.015,0.008),but had no statistical differ-ences between the two groups after 24h treatment(P >0.05).There was no statistical differences between the two groups in the rate of adverse reactions.Conclusion Levosimendan has very favorable efficacy and safety for patients with chronic heart failure combined with acute ST -elevation myocardium infarction after direct PCI.