Application of levosimendan on percutaneous coronary intervention in patients with ischemic heart failure

Abstract

Objective To investigate the effects of levosimendan on percutaneous coronary intervention (PCI) in patients with ischemic heart failure. Methods From January 2013 to June 2016, eighty patients with ischemic heart failure undergoing coronary intervention in Pingdingshan People′s Hospital No.1 were randomly divided into treatment group (40 cases) and control group (40 cases). The treatment group was treated with levosimendan on the basis of routine medicine 2 days before operation, and the control group was given routine medication before operation.The baseline clinical data, operative success rate, complications, left ventricular ejection fraction (LVEF%) after 1 month, 6 min walking distance, plasma brain natriuretic peptide (BNP), creatinine and other cardiac and renal functions were observed and compared between the two groups. Results The differences of the baseline clinical characteristics including age (65.5±3.9 vs.63.9±3.6), male (26 cases (65.0%) vs.23 cases (57.5%) ), hypertension (21 cases (52.5%) vs.19 cases (47.5%) ), diabetes (17 cases (42.5%) vs.14 cases (35.0%) ), hyperlipidaemia (30 cases (75.0%) vs.29 cases (72.5%) ), smoking (21 cases (52.5%) vs.19 cases (47.5%) ), COPD (7 cases (17.5%) vs.6 cases (15.0)%), LDL-C ( (4.5±1.0) mmol/L vs.(4.4±1.1) mmol/L), BMI ( (25.9±3.3) vs.(25.6±3.5) ) were not significant (t/χ2=1.30, 0.47, 0.20, 0.47, 0.07, 0.20, 0.09, 0.49, 0.39, P=0.20, 0.49, 0.66, 0.49, 0.80, 0.66, 0.76, 0.63, 0.70). There was no significant difference in coronary artery lesion between two groups, including single vessel lesion (11 cases (27.5%) vs.15 cases (37.5%) ), double vessel lesion ( (22 cases (55.0%) vs.19 cases (47.5%) ), three vessel lesion ( (7 cases (17.5%) vs.6 cases (15.0%) ) and left main coronary artery disease (7 cases (17.5%) vs.6 cases (15.0%) ) (Z=-0.88, P=0.38). The time of percutaneous coronary intervention ( ( 51.0±8.6) min vs.(49.6±9.6) min), the time of X-ray exposure ( (20.3±7.0) min vs.(18.4±5.6) min), material consumption ( (123.2±16.6) ml vs.(117.3±25.1) ml) between two groups have no difference (t/χ2=0.70, 1.39, 1.24, P=0.49, 0.17, 0.22). There were significant differences between the two groups in the success rate of operation (38 cases (95.0%) vs.31cases (77.5%), heart failure (1 cases (2.5%) vs.6cases (15.0%) ) and complications (2 cases (5.0%) vs.11 cases (27.5%) ) (χ2=5.17, 3.91, 7.44, P=0.02, <0.05, <0.01). Compared with the control group, the treatment group had greater advancement in LVEF, 6 min walking distance, BNP and creatinine level at one month after operation (F=6.10, 63.60, 51.00, 348.00, P=0.02, <0.01, <0.01, <0.01). Conclusion Levosimendan can effectively improve the heart function and renal function, improve the success rate of PCI in patients with ischemic heart failure and reduce the incidence of complications. Key words: Percutaneous coronary intervention; Levosimendan; Ischemic heart failure