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Levosimendan increases time out-of-hospital in decompensated advanced heart failure
Session:
Painel 2 - Insuficiência Cardíaca 10
Speaker:
Gualter Santos Silva
Congress:
CPC 2020
Topic:
D. Heart Failure
Theme:
11. Acute Heart Failure
Subtheme:
11.4 Acute Heart Failure– Treatment
Session Type:
Posters
FP Number:
---
Authors:
Gualter Santos Silva; Mariana Ribeiro Da Silva; Daniel Caeiro; CM Espada Guerreiro; Pedro Gonçalves Teixeira; Pedro Ribeiro Queirós; Francisco Sampaio; Olga Sousa; Adelaide V. Dias; Pedro Braga
Abstract
<p><strong>BACKGROUND:</strong> Advanced heart failure is associated with a high rate of hospitalization due to clinical decompensating. Adding Levosimendan (LVS), an inodilatador which metabolite has long-lasting effect, to intravenous diuretic therapy (standard therapy) is a therapeutic option in these patients, although the magnitude of the short and long-term benefit still remains controversial.</p> <p><strong>OBJECTIVE:</strong> The aim of this study was to determine whether combination of LVS with standard therapy in patients with decompensated advanced heart failure (DAHF) increases time out-of-hospital compared to standard therapy alone. The secondary endpoint was duration of hospital stay for each type of hospitalization</p> <p><strong>METHODS AND RESULTS: </strong>We included patients between January 2015 and October 2018, who met the following criteria: at least one hospitalization with standard therapy and at least one hospitalization with standard therapy plus LVS, separated less than 6 months from each other.</p> <p>From a total of 71 patients who took LVS, 7 patients met the inclusion criteria. All these patients were male, mean age was 64,1 ± 10,6 years, mean left ventricular ejection fraction was 24,6 ± 7,3% and 71,4% had ischemic cardiomyopathy. A total of 22 hospitalizations were analysed (12 with standard therapy plus LVS and 10 with standard therapy), with 4 patients having more than two hospitalizations.</p> <p>The administration of LVS increased the time out-of-hospital until readmission compared to standard therapy alone (70.5 days vs 34.7 days, p = 0.023). The length of stay during LVS administration was longer (12.1 days vs 6.0 days, p <0.001).</p> <p>In 75% of cases after LVS infusion patients stay out-of-hospital more than 2 months while after standard therapy this event occurred only once (10%). 1-year mortality was 71,4%.</p> <p><strong>CONCLUSION:</strong> Use of Levosimendan increases time out-of-hospital in patients with decompensated advanced heart failure. This is an opportunity to improve quality of life in patients with severe disease and recurrent hospitalizations.</p>
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