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

Author

Listed:
  • Christian Reiterer

    (Division of General Anaesthesia and Intensive Care Medicine)

  • Barbara Kabon

    (Division of General Anaesthesia and Intensive Care Medicine)

  • Alexander Taschner

    (Division of General Anaesthesia and Intensive Care Medicine)

  • Alexandra Graf

    (Center for Medical Data Science)

  • Nikolas Adamowitsch

    (Division of General Anaesthesia and Intensive Care Medicine)

  • Katharina Horvath

    (Division of General Anaesthesia and Intensive Care Medicine)

  • David Emler

    (Division of General Anaesthesia and Intensive Care Medicine)

  • Oliver Zotti

    (Division of General Anaesthesia and Intensive Care Medicine)

  • Nicole Hantakova

    (Division of General Anaesthesia and Intensive Care Medicine)

  • Beatrix Hochreiter

    (IT Systems and Communications)

  • Melanie Fraunschiel

    (IT Systems and Communications)

  • Theresa Clement

    (Division Nursing Science with Focus on Person-centred Care Research)

  • Edith Fleischmann

    (Division of General Anaesthesia and Intensive Care Medicine)

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.

Suggested Citation

  • Christian Reiterer & Barbara Kabon & Alexander Taschner & Alexandra Graf & Nikolas Adamowitsch & Katharina Horvath & David Emler & Oliver Zotti & Nicole Hantakova & Beatrix Hochreiter & Melanie Frauns, 2025. "Levosimendan for postoperative subclinical heart failure after noncardiac surgery: a randomized, double-blinded, phase III trial," Nature Communications, Nature, vol. 16(1), pages 1-8, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-60601-y
    DOI: 10.1038/s41467-025-60601-y
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