Efficacy and safety of levosimendan in Chinese elderly patients with Takotsubo syndrome

Background: Takotsubo syndrome has a low global incidence, but it is observed more and more in clinical practice. Only case reports and series have been published, while prospective studies are still necessary. This study aimed to explore the efficacy and safety of levosimendan in elderly with Takotsubo syndrome. Methods: This study followed a prospective, randomized and double-blinded design. All 200 consecutive patients (>65 years) with Takotsubo syndrome were randomly assigned into a levosimendan group (n=100) and a control group (n=100). The control group underwent regular treatment, and the levosimendan group was additionally administrated with levosimendan. Results: Age of all patients was 71 [66-85] years, and there were 138 females (69%). Baseline characteristics between the two groups had no significant difference before treatment (P>0.05 for all). In the levosimendan group on the 30 and 180 days after treatment, left ventricular ejection fraction was significantly higher, and New York Heart Association class and N-terminal pro-brain natriuretic peptide levels were significantly lower, than those in the control group (P<0.05 for all). Systolic blood pressure, diastolic blood pressure, heart rate and serum creatinine levels had no significant difference between the two groups (P>0.05 for all). Conclusions: Levosimendan showed reliable efficacy and safety in Chinese elderly patients with Takotsubo syndrome, supporting the idea that levosimendan has the potential to be an essential drug applied for patients with Takotsubo syndrome.