Meta-analysis Of Intravenous Levosimendan And Dobutamine In The Treatment Of Acute Decompensated Heart Failure

Objective The efficacy and safety of levosimendan injection(LI)in the treatment of acute decompensated heart failure(ADHF)with dobutamine infusion was systematically and comprehensively evaluated.Methods Through the computer online landing China Knowledge Network,Wanfang Medical Database,pubmed database,cochrane library and embase database and other large databases,find levosimendan injection and dobutamine injection for the treatment of acute decompensated heart failure(ADHF)Randomized Controlled Trials RCTs were updated to December 2016.Based on the early incorporation and exclusion criteria,a rigorous and independent literature screening is performed by the Scalar Evaluator to extract relevant information and to assess the bias risk of the included RCTs(Assessment Tool: Cochrane Bias Risk Assessment Tool),and finally REVMAN 5.3 software for meta-analysis.Results In the final study,23 RCTs were included in the study,and data were available from some of the clinical trials.Only 18 data were available for this study.Eighteen studies compared the clinical efficacy of LI and dobutamine in ADHF.Meta-analysis showed that:(OR = 2.98,95%CI: 2.34-3.78,P <0.05),the distinction was statistically significant;the difference was statistically significant.Compared with dobutamine,LI improved the left ventricular ejection fraction(LVEF)in patients with ADHF(MD = 2.84,P <0.05),and the difference was statistically significant(95%CI: 2.02-3.66,P <0.05),the difference was statistically significant;Compared with dobutamine,LI could effectively improve SV(MD)in ADHF patients(P <0.05).Conclusion: Compared with dobutamine,the improvement of hemodynamics(including stroke volume SV and pulmonary capillary wedge pressure PCWP)(95% CI: 6.52,95% CI:(5.70,7.34),P <0.05),the difference was statistically striking.Compared with dobutamine,LI could effectively reduce PCWP in ADHF patients(MD =(-6.63,-2.52),P <0.05),the difference was statistically significant;There was no striking difference between the levosimendan group and the dobutamine group(OR = 0.90,95% CI:(0.71,1.14),P> 0.05).No serious adverse effect was observed in LI.Conclusions The conclusion of this study is that levosimendan injection(LI)significantly improves the clinical outcome of ADHF compared with dobutamine injection,but there is no significant difference in the incidence of adverse events.