Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty

Background Cardiogenic shock (CS) after ST elevation myocardial infarction (STEMI) worsens patientʹs outcome. Levosimendan treatment offers short-term survival benefit in acute heart failure but its effect on long-term outcome remains unclear. We sought to assess the effect on long-term survival of levosimendan compared to dobutamine treatment in patients with STEMI revascularized by primary coronary angioplasty (PCI) who subsequently developed CS. Methods and results Twenty-two consecutive STEMI patients with CS after PCI randomized to receive levosimendan or dobutamine treatment for 24 h were followed-up for twelve months. Complete follow-up was obtained in 100% of them. The endpoint was cardiac death. Baseline clinical and haemodynamic characteristics were similar in both groups. The probability of survival calculated with Kaplan–Meier curves analysis showed no statistically significant differences between both groups (p = 0.24). Conclusions Levosimendan compared to dobutamine did not improve long-term survival in STEMI patients revascularized by PCI who developed CS.