Levosimendan for postoperative subclinical heart failure after noncardiac surgery: a randomized, double-blinded, phase III trial

Christian Reiterer, Barbara Kabon, Alexander Taschner, Alexandra Graf, Nikolas Adamowitsch, Katharina Horvath, David Emler, Oliver Zotti, Nicole Hantakova, Beatrix Hochreiter, Melanie Fraunschiel, Theresa Clement, Edith Fleischmann

Research output: Journal article (peer-reviewed)Journal article

Abstract

The effect of Levosimendan on postoperative natriuretic peptides in noncardiac surgical patients remains unknown. Thus, this study evaluates the effect of a perioperative levosimendan administration on postoperative N-terminal brain pro natriuretic peptide (NT-proBNP) concentrations. In this prospective, double-blinded, parallel group, placebo-controlled, phase III trial 115 patients were assigned to perioperative single-dose of 12.5 mg of levosimendan and 115 to placebo between October 2020 through November 2023 (clinicaltrials.gov: NCT04329624). The primary outcome was postoperative maximum NT-proBNP concentration within the first 3 postoperative days. 228 patients completed the trial. Postoperative maximum NT-proBNP concentrations did not differ significantly between the groups (effect estimate: -64.51 ng.L-1; 95% CI -332.66 to 195.56; p = 0.61). Here, we show that perioperative levosimendan administration did not lead to a significantly lower release in postoperative NT-proBNP after noncardiac surgery.

Original languageEnglish
Article number5847
Pages (from-to)5847
JournalNature Communications
Volume16
Issue number1
DOIs
Publication statusPublished - Dec 2025

Keywords

  • Humans
  • Simendan/therapeutic use
  • Male
  • Natriuretic Peptide, Brain/blood
  • Female
  • Double-Blind Method
  • Aged
  • Heart Failure/drug therapy
  • Middle Aged
  • Peptide Fragments/blood
  • Postoperative Complications/drug therapy
  • Prospective Studies
  • Cardiotonic Agents/therapeutic use

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