• Int. J. Cardiol. · Sep 2013

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

    • Emiliano Angeloni, Giovanni Melina, Antonino Roscitano, Simone Refice, Fabio Capuano, Cosimo Comito, Umberto Benedetto, and Riccardo Sinatra.
    • Sapienza, University of Rome, Policlinico Sant'Andrea, Department of Cardiac Surgery, Rome, Italy. emilianoangeloni@gmail.com
    • Int. J. Cardiol. 2013 Sep 1;167(5):1961-6.

    BackgroundPerioperative 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.MethodsA 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.ResultsOverall 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.ConclusionPatients perioperatively receiving enoximone showed a statistically significant better renal function after cardiac surgery.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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