Primary Outcome Measures:
- Efficacy: Changes in regional contractility, BNP and clinical symptoms. [ Time Frame: At 5 days ] [ Designated as safety issue: No ]
Secondary Outcome Measures:
- Mace: Time to death, non-fatal myocardial infarction or revascularization during the first 6 weeks and 6 months. [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
- Time to rehospitalisation for decompensated heart failure. [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
- Days hospitalised/days in intensive/coronary care. [ Time Frame: At discharge ] [ Designated as safety issue: No ]
- Changes in inflammation markers. [ Time Frame: 1, 5 days, 6 weeks. ] [ Designated as safety issue: No ]
- Improvement in creatinine clearance. [ Time Frame: 5 days ] [ Designated as safety issue: Yes ]
- Improvement of hemodynamic parameters. [ Time Frame: 5 days ] [ Designated as safety issue: Yes ]
- Central venous oxygen saturation. [ Time Frame: 1 day ] [ Designated as safety issue: No ]
- Total mortality. [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
- Arrhythmias, hypotension, ischaemic episodes. [ Time Frame: 5 days ] [ Designated as safety issue: Yes ]
Double blind placebo-controlled study with parallel groups in patients with acute PCI treated myocardial infarction complicated with decompensated heart failure. The study include a prospectively defined subgroup of patients in cardiogenic shock. Treating acute myocardial infarction with PCI restores blood flow, but decreased contractility remains for hours and days due to stunned myocardium. Levosimendan has both inotropic and vasodilatory effects which could support the failing heart after treating the acute myocardial infarction with PCI and may improve myocardial stunning and decrease pro-inflammatory cytokines. Levosimendan could improve myocardial contractility, symptoms and outcome without adverse effects. The aims of the study are to investigate whether a 24 hour infusion with levosimendan could improve regional contractility measured by echocardiography, improve BNP levels, reduce the levels of pro-inflammatory cytokines and improve symptoms in patients with acute decompensated heart failure during the first 24 hours after acute PCI.