Levosimendan increases time out-of-hospital in decompensated advanced heart failure

Abstract Funding Acknowledgements Type of funding sources: None. Background Advanced heart failure is associated with a high rate of hospitalization due to clinical decompensating. Adding Levosimendan (LVS), an inodilatador which metabolite has long-lasting effect, to intravenous diuretic therapy (standard therapy) is a therapeutic option in these patients, although the magnitude of the short and long-term benefit still remains controversial. Objective The aim of this study was to determine whether combination of LVS with standard therapy in patients with decompensated advanced heart failure (DAHF) increases time out-of-hospital compared to standard therapy alone. The secondary endpoint was duration of hospital stay for each type of hospitalization. Methods and Results Retrospective analysis of patients with advanced heart failure who met the following criteria: at least one hospitalization with standard therapy and at least one hospitalization with standard therapy plus LVS, separated less than 6 months from each other. From a total of 71 patients who took LVS in our cardiac care unit, 7 patients met the inclusion criteria. All these patients were male, mean age was 64,1 ± 10,6 years, mean left ventricular ejection fraction was 24,57 ± 7,3% and 71,4% had ischemic cardiomyopathy. A total of 22 hospitalizations were analysed (12 with standard therapy plus LVS and 10 with standard therapy), with 4 patients having more than two hospitalizations. The administration of LVS increased the time out-of-hospital until readmission compared to standard therapy alone (70.5 days vs 34.7 days, p = 0.023) (figure 1). The length of stay during LVS administration was longer (12.1 days vs 6.0 days, p <0.001). In 75% of cases after LVS infusion patients stay out-of-hospital more than 2 months while after standard therapy this event occurred only once (10%) (figure 2). 1-year mortality was 71,4%. Conclusion Use of Levosimendan increases time out-of-hospital in patients with DAHF. This is an opportunity to improve quality of life in patients with severe disease and recurrent hospitalizations.