Short-term Effects Of Levosimendan On Refractory Heart Failure Patients With NSTE-ACS

ObjectiveTo observe the short-term effects of multiple organ and function in patients with refractory heart failure combined with non-ST-segment elevation acute coronary syndrome after infusion of levosimendan,in order to provide a better reference for the formulation of treatment plan for such patients after admission.MethodFrom October 2016 to October 2018,63 patients with refractory heart failure due to non-ST-segment elevation acute coronary syndrome combined with reduced ejection fraction were selected from the Department of Cardiovascular Medicine,First Affiliated Hospital of Henan University in the light of the inclusion and exclusion criteria.According to the specific situation,63 patients were divided into two groups,that is the treatment group and the control group.31 patients in the treatment group were given levosimendan on the basis of standardized anti-ischemia and anti-heart failure treatment after admission,while 32 in the control group received only standardized anti-ischemia and anti-heart failure treatment,the same as treatment group.There were no significant differences in the age,height,weight,heart rate,and systolic blood pressure between the two groups.After 5 days of treatment,we observed and compared the changes of the patients' left ventricular ejection fraction(LVEF),cardiac index(CI),NT-proBNP,alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),serum creatinine(SCr),prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)between the two groups.The treatment results were statistically analyzed with the method of SPSS22.0.Resuts1.There were significant differences in LVEF and CI between the treatment group before and after treatment(LVEF:P<0.05;CI:P<0.05).There were significant differences in LVEF between the control group before and after treatment while CI were not the same(LVEF:P<0.05;CI:P>0.05),and the comparison between the two groups after treatment showed that levosimendan could improve LVEF and CI better than general treatment(P<0.05).2.There were significant differences in NT-proBNP between the two groups before and after treatment(treatment group:P<0.05;control group:P<0.05),and the difference between the two groups after treatment showed that the decrease of NT-proBNP using levosimendan was more than that of the general treatment(P<0.05).3.There was no significant difference in ALT between the two groups before and after treatment(treatment group:P>0.05;control group:P>0.05),and the AST between them had a difference(treatment group:P<0.05;control group:P>0.05),there was no significant difference in ALT between the two groups(P>0.05),and the AST comparison was statistically significant(P<0.05).4.There was no significant difference in SCr and BUN between the treatment group before and after treatment(SCr:P>0.05;BUN:P >0.05).There was no significant difference in SCr between the control group and the control group(SCr:P>0.05),but the decrease of BUN was statistically significant(P<0.05).However,there was no significant difference in the changes of Scr and BUN between the two groups after treatment(P>0.05).5.There was no significant difference in PT and TT between the treatment group before and after treatment(PT:P>0.05;TT:P>0.05),and APTT The difference was statistically significant(P< 0.05).There was no significant difference in PT and APTT between the control group before and after treatment(PT:P>0.05;APTT:P>0.05),while TT The difference was statistically significant(P< 0.05).There was no significant difference in PT between the two groups after treatment(P>0.05).It was not considered that the PT changes were different between the two groups.The changes of APTT and TT were statistically significant(P<0.05).ConclusionFrom our research we can conclude that the short-term effects of the early use of levosimendan on the refractory heart failure patients with non-ST-segment elevation acute coronary syndrome are better than those of the traditional treatment.The short-term effects are: increasing ejection fraction and cardiac index as soon as possible;reducing NT-proBNP more;reducing the concentration of AST;affecting coagulation system in vivo...