The effect of levosimendan use on early postoperative clinical outcomes in patients undergoing coronary artery bypass surgery

Introduction: In this study, we aimed to evaluate the early postoperative clinical effect of perioperative levosimendan use in patients undergoing coronary artery bypass surgery. We retrospectively analyzed whether there was a difference between the groups formed by categorizing the patients into subgroups based on their ejection fractions and comparing these groups statistically. Materials and Methods: Data from 97 patients who underwent coronary artery bypass surgery with cardiopulmonary bypass and received levosimendan infusion in the preoperative period were retrospectively analyzed. The patients were divided into two groups based on ejection fraction: Group 1=ejection fraction %25-35 and Group 2=ejection fraction %36-45. Data collected included patients' age, gender, type of operation, body mass index (BMI), preoperative EF, smoking status, LDL, hematocrit, platelet count, white blood cell count, HbA1c, creatinine, AST, ALT, cardiopulmonary bypass duration, cross clamp duration, amount of postoperative inotropic support, intensive care unit stay, length of hospital stay, morbidity, and mortality. These data were evaluated by comparing the groups with each other. Results: In our study, there was no statistically significant difference between the two groups in terms of morbidity, mortality, cardiopulmonary bypass duration, cross clamp duration, postoperative inotropic requirement, and length of stay in the intensive care unit. When length of hospital stay were compared, the mean discharge time was 15.72 days ± 5.75 in Group 1 and 13.25 days ± 4.12 in Group 2 (p=0.019*). It was observed that patients in Group 1 were discharged significantly later than those in Group 2. (* = p < 0.05 is statistically significant.) Conclusion: The perioperative use of levosimendan during the coronary artery bypass surgery process did not create a statistically significant difference in the postoperative process among patient groups with different EF. It is a well-known clinical fact that mortality and morbidity increase as EF decreases, and the similarity in outcomes between the two groups, except for the length of hospital stay, can be attributed to the positive effect of levosimendan. It can be suggested that when levosimendan is used, patients' clinical outcomes may be similar regardless of low EF data.