Levosimendan combined with aortic balloon counterpulsation could effectively improve the prognosis of patients with acute myocardial infarction complicated with cardiogenic shock
Objective:To evaluate the efficacy of levosimendan combined with intra-aortic balloon counterpulsation(IABP)in patients with acute myocardial infarction(AMI)complicated with cardiogenic shock(CS)and safety.Methods:A total of 82 patients with AMI combined with CS implantation with IABP who underwent acute percutaneous coronary inter-vention(PCI)were collected and randomly divided into an observation group(traditional medicine+levosimendan)and a control group(traditional medicine).NT-proBNP,HsCRP and cTn1 levels were detected.The IABP assistance time,CCU stay days and overall hospitalization days,the incidence of major adverse cardiac events 30 days after myocardial infarction(recurrent myocardial infarction,stroke,revascularization,death and rehospitalization rate)were observed.Results:After 5 days of treatment,as compared with the control group,the NT-proBNP(-3895.37±1589.59 vs.-2568.53±1864.23 pg/mL,P=0.0026),the HsCRP(-42.56±20.35 vs.-25.63±12.69 mg/L,P=0.0032)and peak troponin(89.65±36.58 vs.98.56±32.69 mg/L,P=0.042)significantly decreased in the observation group.The observation group had shorter duration of IABP(4.5±2.5 vs.6.5±3.5 days,P=0.032),shorter CCU stay time(7.5±3.5 vs.9.5±4.5 days,P=0.039)and total hospital stay time(10.5±5.5 days vs.13.5±6.5 days,P=0.025)than in the control group.There was no significant difference in mortality during hospitalization between the two groups(P=0.696).The main adverse cardiovas-cular events in the observation group within 30 days showed a decreasing trend as compared with the control group(19.05％vs.25.00％,P=0.515).Within 30 days,the observation group had fewer emergency hospital visits(1.2±0.8 vs.2.2± 1.8,P=0.042)and fewer readmissions(0.8±1.2 vs.1.5±1.6,P=0.049)than the control group.Standard EQ-5D-3L health questionnaire score in the observation group significantly decreased at discharge(P=0.038)and 30 days(P=0.029)as compared with the control group.Conclusion:Levosimendan combined with IABP is effective,safe and reliable in patients with AMI and CS.
NETL
NSTL
万方数据
