Outcomes of the patients of heart failure with reduced ejection fraction receiving inotropic support in initial 6 hours: Insights from Manipal Heart Failure Registry

Ajit Singh, Sheetal Chauhan, Ganesh Paramasivam, Tom Devasia, Yeshwanth Rao, Prasad Narayana Shetty, Navaneeth Amin, Deepak Uppunda, Hashir Kareem

Research output: Contribution to journalArticle

Abstract

Heart failure (HF) is responsible for 1.8 million admissions annually in India with an additional burden of mortality and re-hospitalizations. Positive inotropes with multiple mechanisms, such as dopamine and levosimendan, are being used for more than three decades to treat the patients of acute HF with reduced ejection fraction (HFrEF). This study compared the outcomes of the dopamine and the levosimendan up to 180 days. We have selected the patients from Manipal Heart Failure Registry who were diagnosed to have HFrEF (left ventricular EF less than 50%) and were initiated on either dopamine or levosimendan in first 6 hours of hospitalization. The study included a total of 187 patients; among them, 120 patients were analyzed in the dopamine group, and 67 patients in the levosimendan group. Dopamine was initiated as intravenous infusion with the dose of 2.5 microgram/kilogram/minute (mcg/kg/minute) and up-titrated up to 10 mcg/kg/minute. Levosimendan was also administered intravenously with a dose of 0.1 mcg/ kg/minute and up-titrated up to 0.4 mcg/kg/minute. The primary outcomes include a composite of all-cause mortality and re-hospitalization at 30-days and 180-days follow-ups. The in-hospital mortality, 30-days mortality and 180-days mortality, and composite outcomes were noted higher in levosimendan treated patients even after matched demographic parameters (age and gender) and comparable comorbidities and risk factors, i.e., smoking, alcohol consumption, hypertension, diabetes mellitus, and atrial fibrillation. However, reduced EF, raised serum creatinine, procalcitonin, and N-terminal pro b-type natriuretic peptide levels and high use of digoxin were noticed in levosimendan group during the initial period of index-hospitalization and these can be considered as confounding factors for future studies.

Original languageEnglish
Pages (from-to)11-17
Number of pages7
JournalJournal of Applied Pharmaceutical Science
Volume9
Issue number8
DOIs
Publication statusPublished - 01-08-2019

Fingerprint

Registries
Heart Failure
Dopamine
Hospitalization
Mortality
Natriuretic Peptides
Digoxin
Calcitonin
Hospital Mortality
simendan
Intravenous Infusions
Alcohol Drinking
Stroke Volume
Atrial Fibrillation
Comorbidity
India
Creatinine
Diabetes Mellitus
Smoking
Demography

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Pharmacology (medical)

Cite this

Singh, Ajit ; Chauhan, Sheetal ; Paramasivam, Ganesh ; Devasia, Tom ; Rao, Yeshwanth ; Shetty, Prasad Narayana ; Amin, Navaneeth ; Uppunda, Deepak ; Kareem, Hashir. / Outcomes of the patients of heart failure with reduced ejection fraction receiving inotropic support in initial 6 hours : Insights from Manipal Heart Failure Registry. In: Journal of Applied Pharmaceutical Science. 2019 ; Vol. 9, No. 8. pp. 11-17.
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Outcomes of the patients of heart failure with reduced ejection fraction receiving inotropic support in initial 6 hours : Insights from Manipal Heart Failure Registry. / Singh, Ajit; Chauhan, Sheetal; Paramasivam, Ganesh; Devasia, Tom; Rao, Yeshwanth; Shetty, Prasad Narayana; Amin, Navaneeth; Uppunda, Deepak; Kareem, Hashir.

In: Journal of Applied Pharmaceutical Science, Vol. 9, No. 8, 01.08.2019, p. 11-17.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcomes of the patients of heart failure with reduced ejection fraction receiving inotropic support in initial 6 hours

T2 - Insights from Manipal Heart Failure Registry

AU - Singh, Ajit

AU - Chauhan, Sheetal

AU - Paramasivam, Ganesh

AU - Devasia, Tom

AU - Rao, Yeshwanth

AU - Shetty, Prasad Narayana

AU - Amin, Navaneeth

AU - Uppunda, Deepak

AU - Kareem, Hashir

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