Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery: An Update Meta-Analysis and Trial Sequential Analysis

Table 1

The main characteristics of included studies.

Study: first author	Year	Mean age of participants; Levosimendan/control (years)	Number of participants	Setting	Preoperative mean EF (%)		Control	Levosimendan Infusion; Dose (μg/kg/min)
			Levosimendan/control		Levosimendan	Control
Al-Shawaf et al.	2006	60.5/58	14/16	Elective CABG surgery, EF ≤ 35%	29 ± 6	31 ± 6	Milrinone	Bolus: 12 μg/kg
								Inf: 0.1–0.2 μg/kg/min
								Duration: 24 h
De hert et al.	2007	67/69	15/15	Elective cardiac surgery with CPB, EF ≤ 30%	24 ± 6	27 ± 3	Milrinone	Bolus: none
								Inf: 0.1 μg/kg/min
								Duration: NR
Levin et al.	2008	62.4/61.7	69/68	Coronary surgery with ECC and manifest LCOS	36.62 ± 4.36	38.22 ± 5.24	Dobutamine	Bolus: 10 μg/kg
								Inf: 0.1 μg/kg/min
								Duration: 24 h
Eriksson et al.	2009	64/64	30/30	CABG with CPB and EF < 50% or acute CHF	36 ± 8	36 ± 8	Placebo	Bolus: 12 μg/kg
								Inf: 0.2 μg/kg/min
								Duration: 24 h
Severi et al.	2011	66/60	11/11	CABG with or without concomitant mitral surgery, EF < 50%	26 ± 6.2	30 ± 6.4	IABP	Bolus: none
								Inf: 0.1 μg/kg/min
								Duration: 24 h
Lomivorotov et al.	2012	57.3/56.8	30/30	CABG with CPB, EF < 35%	31 (28–33)	30 (29–33)	IABP	Bolus: 12 μg/kg
								Inf: 0.1 μg/kg/min
								Duration: 24 h
Levin et al.	2012	63.7/62.9	127/125	Cardiac surgery with CPB, EF < 25%	17.56 ± 3.24	18.62 ± 2.12	Placebo	Bolus: 10 μg/kg
								Inf: 0.1 μg/kg/min
								Duration: 24 h
Sharma et al.	2014	53.95/54.55	20/20	CABG and mitral valve repair, EF < 25%	23.55 ± 4.87	22.55 ± 0.92	Placebo	Bolus: none
								Inf: 200 μg/kg
								Duration: 24 h
Baysal et al.	2014	56.73/58.41	64/64	Mitral valve surgery, EF ≤ 45%	35.0 (20–50)	37.5 (25–50)	Standard inotropic agents	Bolus: 6 μg/kg
								Inf: 0.1 μg/kg/min
								Duration: 24 h
Erb et al.	2014	69.5/63.4	17/16	Elective CABG with or without valve surgery, EF ≤ 35%	22.0 ± 4.5	22.4 ± 5.5	Placebo	Bolus: none
								Inf: 0.1 μg/kg/min
								Duration: NR
Knezevic et al.	2014	53/49	47/47	Heart transplantation and advanced heart failure	20 ± 6	21 ± 7	Standard inotropic or vasopressor	Bolus: none
								Inf: 0.1 μg/kg/min
								Duration: NR
Shah et al.	2014	59.91/61.32	25/25	OPCABG, EF < 30%	22.45 ± 4.06	22.56 ± 3.41	Placebo	Bolus: none
								Inf: 0.13 μg/kg/min
								Duration: 24 h
Anastasiadis et al.	2016	61.1/62.2	16/16	CABG, EF ≤ 40%	35.7 ± 4.9	37.5 ± 3.4	Placebo	Bolus: none
								Inf: 0.1 μg/kg/min
								Duration: 24 h
Mehta et al.	2017	65/65	428/421	Cardiac surgery with CPB, EF ≤ 35%	26 (24–32)	27 (22–31)	Placebo	Bolus: 0.2 μg/kg/min
								Inf: 0.1 μg/kg/min
								Duration: 24 h
Cholley et al.	2017	69/67	167/168	CABG with CPB or combined with valve surgery, EF ≤ 40	≤40	≤40	Placebo	Bolus: none
								Inf: 0.1 μg/kg/min
								Duration: 24 h

CABG: coronary aortic bypass grafting; OPCABG: off-pump coronary aortic bypass grafting; CBP: cardiopulmonary bypass; EF: ejection fraction; ECC: extracorporeal circulation; LCOS: low cardiac output syndrome; CHF: congestive heart failure; IABP: intra-aortic balloon pump.