Scientific publications
Repetitive ambulatory levosimendan as a bridge to heart transplantation
Javier de Juan Bagudá 1 , Fernando de Frutos 2 , Raquel López-Vilella 3 , David Couto Mallón 4 , Joan Guzman-Bofarull 5 , Zorba Blazquez-Bermejo 6 , Manuel Cobo-Belaustegui 7 , Cristina Mitroi 8 , Francisco J Pastor-Pérez 9 , Carlos Moliner-Abós 10 , Diego Rangel-Sousa 11 , Beatriz Díaz-Molina 12 , Javier Tobar-Ruiz 13 , Nahikari Salterain Gonzalez 14 , José Manuel García-Pinilla 15 , María Dolores García-Cosío Carmena 16 , María Generosa Crespo-Leiro 17 , David Dobarro 18 , Luis Almenar 19 , Juan F Delgado-Jiménez 20 , Emilio Paredes-Galán 21 , Francisco González-Vílchez 7 , José González-Costello 2
Introduction and objectives
Repetitive ambulatory doses of levosimendan are an option as a bridge to heart transplantation (HT), but evidence regarding the safety and efficacy of this treatment is scarce. The objective of the LEVO-T Registry is to describe the profile of patients on the HT list receiving levosimendan, prescription patterns, and clinical outcomes compared with patients not on levosimendan.
Methods
We retrospectively reviewed all patients listed for elective HT from 2015 to 2020 from 14 centers in Spain.
Results
A total of 1015 consecutive patients were included, of whom 238 patients (23.4%) received levosimendan. Patients treated with levosimendan had more heart failure (HF) admissions in the previous year and a worse clinical profile. The most frequent prescription pattern were fixed doses triggered by the patients’ clinical needs. Nonfatal ventricular arrhythmias occurred in 2 patients (0.8%). No differences in HF hospitalizations were found between patients who started levosimendan in the first 30 days after listing and those who did not (33.6% vs 34.5%; P = .848). Among those who did not, 102 patients (32.9%) crossed over to levosimendan after an HF admission. These patients had a rate of 0.57 HF admissions per month before starting levosimendan and 0.21 afterwards. Propensity score matching analysis showed no differences in survival at 1 year after listing between patients receiving levosimendan and those who did not (HR, 1.03; 95%CI, 0.36-2.97; P = .958) or in survival after HT (HR, 0.97; 95%CI, 0.60-1.56; P = .958).
Conclusions
Repetitive levosimendan in an ambulatory setting as a bridge to heart transplantation is commonly used, is safe, and may reduce HF hospitalizations.
CITATION Rev Esp Cardiol (Engl Ed). 2023 Jul 27:S1885-5857(23)00204-9. doi: 10.1016/j.rec.2023.07.002
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