Comparing Heart Failure Treatments in Elderly Patients
Author Information
Author(s): Dobarro David, Raposeiras-Roubin Sergio, Almenar-Bonet Luis, Solé-González Eduard, Padilla-Lopez Mireia, Diez-Lopez Carles, Castrodeza Javier, García-Cosío Maria Dolores, Cobo-Marcos Marta, Tobar Javier, Codina Pau, Lopez-Fernandez Silvia, Pastor Francisco, Rangel-Sousa Diego, Barge-Caballero Eduardo, Diaz-Molina Beatriz, Barrio-Rodriguez Alfredo, Burgos-Palacios Virginia, Álvarez-García Jesús, González-Fernández Oscar, Grau-Sepulveda Andrés, Garcia-Pinilla José Manuel, Ruiz-Bustillo Sonia, Mendez-Fernández Ana B., Vaqueriza-Cubillo David, Sagasti-Aboitiz Igor, Rodriguez-Santamarta Miguel, Lozano-Bahamonde Ainara, Abecia Ana, Gómez-Otero Inés, Marzoa Raquel, González-Babarro Eva, Gómez-Bueno Manuel, Gonzalez-Costello José, Morais João
Primary Institution: Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, IIS Galicia Sur, Spain
Hypothesis
Is intermittent levosimendan as effective as LVAD therapy for elderly patients with advanced heart failure who are not candidates for heart transplantation?
Conclusion
In elderly patients with advanced heart failure who are not candidates for heart transplantation, LVAD therapy offers significantly better long-term outcomes compared to intermittent levosimendan.
Supporting Evidence
- LVAD patients had a median survival of 1486 days compared to 741 days for LEVO-D patients.
- 52.3% of LEVO-D patients died during follow-up compared to 42.3% of REGALAD patients.
- Intermittent levosimendan showed similar one-year outcomes to LVAD in terms of heart failure admissions.
Takeaway
This study looked at two treatments for very sick heart patients who can't get a heart transplant. It found that a special heart pump (LVAD) works better in the long run than a medicine called levosimendan.
Methodology
The study compared two multicenter cohorts of patients from the LEVO-D and REGALAD registries, analyzing survival and hospitalization outcomes.
Potential Biases
Unmeasured confounding factors may not be corrected in propensity score matching.
Limitations
The study is retrospective and may have biases; the sample size for the propensity analysis was small.
Participant Demographics
Elderly patients with advanced heart failure, many with comorbidities.
Statistical Information
P-Value
p = 0.03
Confidence Interval
95% CI: 611–870 for LEVO-D, 95% CI: 969–2002 for REGALAD
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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