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Perioperative administration of enoximone and renal function after cardiac surgery: a propensity-matched analysis.

Abstract：

BACKGROUND:Perioperative administration of enoximone has been shown to improve hemodynamics, organ function, and inflammatory response. Aim of the present study is to evaluate the impact of enoximone on postoperative renal function after on-pump cardiac surgery. METHODS:A total of 3727 patients undergoing cardiac surgery at one Institution between May 2004 and November 2010 were reviewed. A propensity score was built and a 1:1 perfect matching was performed, providing two fairly comparable cohorts of 712 patients each, receiving or not enoximone after surgery. Renal function was evaluated by lower glomerular filtration rate (GFR) value reached postoperatively. RESULTS:Overall 30-day mortality rate was 4.3% (62/1424). Cumulative incidence of postoperative renal failure (RF) was 157/1424(11%), of which 99/1424(7%) needed renal replacement therapy. Mean lower postoperative GFR in patients who received or not enoximone was 63 ± 30.1 and 53.5 ± 26.1 ml/min/1.73 m(2) (p<0.0001), respectively. At multivariable analysis age (OR2.75, p=0.0004), diabetes (OR1.82, p=0.006), preoperative GFR (OR3.81, p<0.0001), preoperative cardiogenic shock (OR1.65, p=0.004), previous cardiac surgery (OR2.12, p=0.0002), type of intervention (OR1.96, p=0.005), and enoximone (OR0.38, p=0.001) were found to be independently associated with postoperative RF. Logistic regression analysis showed that the administration of enoximone (OR0.41, p=0.0001), and of no inotropes (OR0.27, p<0.0001) were protective vs. the occurrence of postoperative RF. CONCLUSION:Patients perioperatively receiving enoximone showed a statistically significant better renal function after cardiac surgery.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Angeloni E,Melina G,Roscitano A,Refice S,Capuano F,Comito C,Benedetto U,Sinatra R

doi

10.1016/j.ijcard.2012.05.021

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

1961-6

issue

5

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(12)00632-8

journal_volume

167

pub_type

杂志文章

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