| Objective: To investigate the effect of levosimendan on acute myocardial infarction with heart failureMethods:The database was searched by computer such as Pubmed 、Cochrane library 、 EMBASE 、 Ovid 、 Wanfang 、 CNKI 、 VIP and CBM.Randomized controlled study(RCT)for the treatment of acute myocardial infarction with heart failure with levosimendan and conventional therapy are included(the duration retrieval from database inception to February 2017).Quality evaluation and data extraction were carried out on studies that met the inclusion criteria.Use the RevMan 5.2 software to assess and give a meta-analysis.The outcomes include Brain Natriuretic Peptide(BNP)、N-terminal pro-brain natriuretic(NT-proBNP)、LVEF(Left ventricular ejection fraction)、 CI(heart index)、 SV(stroke volume)、 LVEDV(left ventricular end-diastolic volume)、heart rate(HR)and Efficacy.Results: In this study a total of 25 studies were included,involving 1815 patients,917 cases of leosimendan group,898 cases of conventional treatment group.Compared with the conventional treatment group,the leosimendan group has a significantly decrease in the BNP(SMD=﹣0.43,95%CI:﹣0.68~﹣0.17,P=0.0009)、NT-proBNP(SMD=﹣0.70,95%CI:﹣1.07~﹣0.34,P=0.0002)and a significantly decrease in the LVEDV(SMD= ﹣ 0.24,95%CI : ﹣0.44~0.04,P=0.02);A significant increase in LVEF(SMD=5.34,95%CI:4.31~6.38,P<0.00001)、CI(SMD=2.36,95%CI:1.89~2.84,P<0.00001)、SV(SMD=9.18,95%CI:6.86~11.51,P<0.00001)and clinical outcome(OR=2.38,95%CI:2.33~4.90,P<0.00001);Have no obvious effect on HR(SMD=﹣4.01,95%CI:﹣8.19~0.18,P=0.06).Conclusion: Levosimendan significantly reduced the BNP and NT-proBNP in patients with heart failure after acute myocardial infarction compared with conventional therapy;Levosimendan significantly increased the LVEF、CI and SV of patients with heart failure after acute myocardial infarction compared with conventional therapy;levosimendan significantly reduced LVEDV in patients with heart failure after acute myocardial infarction compared with conventional therapy;levosimendan did not significantly increase the heart rate of patients with heart failure after acute myocardial infarction compared with conventional therapy;Also can significantly increase the clinical efficiency compared with conventional therapy.Due to late into the research and the quality is not high,lack of long-term follow-up data and clinical adverse reactions,failed to more long-term outcome and safety of levosimendan,later need more multicenter,randomized,double-blind trial to further confirm the clinical effects of levosimendan,security,and prognosis. |
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