This study aimed to compare the effects of levosimendan versus dobutamine on short-term clinical outcomes in patients with ADHF.
Methods
We performed a systematic search of PubMed (MEDLINE), Embase and the Cochrane Library to identify randomised controlled trials (RCTs) comparing levosimendan and dobutamine in adults with ADHF. The primary outcome was all-cause mortality within 30 days. Secondary outcomes included length of hospital stay and improvement in glomerular filtration rate. Meta-analyses were conducted using a random-effects model.
Results
Eight RCTs (n=1973) were included. Levosimendan significantly reduced 30-day mortality compared with dobutamine (OR 0.53, 95% CI 0.31 to 0.91; I² = 27%). Hospital stay was shortened by a mean of 2.4 days (95% CI –3.3 to –1.5), though heterogeneity was high. Limited data suggested renal function benefits. Certainty of evidence was moderate for mortality and very low for hospital stay.
Conclusions. Levosimendan reduced short-term mortality and hospital stay compared with dobutamine in patients with ADHF, although the certainty of evidence was moderate for mortality and very low for hospital stay.
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