Comparison Of The Clinical Efficacy In The Treatment Of Heart Failure With Reduced Ejection Fraction By Of Sacubitril/valsartan And Perindopril

Objective: The purpose of this study is to compare the clinical efficacy of sacubitril/valsartan and perindopril in the treatment of patients with heart failure with reduced ejection fraction(HFrEF)after one month and three months,to observe the therapeutic effect and safety of sacubitril/valsartan and perindopril in the treatment of patients with heart failure with reduced ejection fraction(HFrEF).Methods: From January 2018 to January 2019,we enrolled 100 patients who were hospitalized in our hospital for HFrEF.The patients were randomly divided into two groups.The experimental group treat with sacubitril/valsartan(The starting dose was 50 mg twice daily.If the patient’s blood pressure is tolerated,the dose is doubled every 2 weeks until the target dose of 200 mg twice daily;If the patient’s blood pressure is not tolerated,continue to maintain the maximum dose tolerated).The control group treat with perindopril(The starting dose was 4mg once daily.If the patient is tolerant,it can gradually reach the maximum dose of 8mg once a day;if the patient is intolerant,continue to maintain the maximum dose that can be tolerated).Both groups received the same conventional drugs for anti-heart failure.Collecting the datas of systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),brain natriuretic peptide precursor(NT-proBNP),left atrial diameter(LA),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),6 minute walk test.Results: After one month and three months of treatment with sacubitril/valsartan,The SBP,DBP,HR,NT-proBNP levels,LA,LVESD,LVEDD,LVEF,6-minute walk test were improved compared with those before treatment.It was statistically significant(P<0.05).And the SBP,DBP,HR,NT-proBNP levels,LA,LVESD,LVEDD,LVEF,6-minute walk test were also improved compared with those before treatment in the perindopril group.In the same,it was also statistically significant(P<0.05).After one month of treatment,the heart rate of the sacubitril/valsartan group was significantly lower than that of the perindopril group(P=0.014).Furthermore,the NT-proBNP levels,6-minute walk test of the sacubitril/valsartan group were significantly improved compared with the perindopril group after three months treatments(P<0.05).There was no significant difference in overall efficiency between the two groups after three months treatments(P>0.05).There were also no significant differences in adverse reactions and cardiovascular-related disease mortality between the two groups(P>0.05).Conclusions: Both sacubitril/valsartan and perindopril can effectively improve cardiac function in patients with heart failure with reduced ejection fraction.And it is safe.The clinical efficacy of sacubitril/valsartan is the same as perindopril.