Efficacy Of Angiotensin Receptor-neprilysin Inhibitor In Patients With Chronic Heart Failure

Research background and purposeHeart failure(HF)is one of the most common causes of death and hospitalization in my country.In recent years,the prevalence of heart failure has been increasing year by year with the average age [1].Even if medical treatment continues to progress,heart failure is still a disease with high incidence and high mortality.In recent years,it has been found that the enhanced activity of the natriuretic peptide system(NPs)may benefit patients with heart failure,but inhibition of the degradation of the natriuretic peptide system increases the risk of angioedema.Therefore,the renin-angiotensin-aldosterone system(RAAS)Combining the inhibition with inhibitors of NPs degradation,angiotensin-enkephalinase inhibitor(ARNI)is produced,which controls disease progression through a new mechanism of action,and further optimizes the survival rate,hospital stay and quality of life of patients [2].Because this type of drug has not been used clinically,and related domestic and foreign studies mainly focus on heart failure with reduced ejection fraction(HFr EF),there is insufficient research evidence for patients with heart failure with other characteristics;secondly,clinical research mostly uses drug titration For patients with stable chronic heart failure,the main effect indicators are the readmission rate,the occurrence of cardiovascular events,and the survival rate.There is a lack of observation of the improvement rate of clinical signs in the early stage of medication;current clinical studies mostly select enalapril as the control However,there is evidence that ramipril used in heart failure patients has a better survival rate;therefore,this study aims to analyze whether ARNI is used in patients with heart failure with all characteristics to have obvious benefits;secondly,clinical signs after early application of the drug Whether the improvement is obvious,it has important guiding significance for the medication of patients with chronic heart failure with stable hemodynamics and acute exacerbation;finally,ramipril was selected as a controlled study to enrich the evidence of ARNI medication,and to choose ARNI and ACEI in clinical medication Provide more evidence.Research MethodCollected from January 1,2018 to September 30,2019 in the Department of Cardiology of The First Affiliated Hospital of Henan University,patients diagnosed with chronic heart failure;according to the inclusion and exclusion criteria,select appropriate observation objects into the study,and include the treatment plan Patients with Coubatril valsartan sodium tablets were set as the observation group,and patients with ramipril included in the treatment plan were set as the control group.Further collect patients’ general clinical data,combined medication,baseline data of evaluation indicators(systolic blood pressure,New York heart function(NYHA)classification,serum NT-pro BNP,echocardiographic measurements(left ventricular ejection fraction(LVEF%)),left ventricle End-diastolic diameter(LVEDd mm))and the occurrence of major adverse events.Result1.There were no statistically significant differences in general information,medication regimens,past medical history,and baseline levels before treatment between the two groups.2.After 8 weeks of treatment,the patient’s heart function was significantly improved and the observation results were better than the control group;after treatment,the serum NT-pro BNP concentration was lower than before and more significantly than the control group;left ventricular ejection fraction and left ventricular end-diastolic diameter All were better than before treatment,and the treatment effect was better than that of the control group;the systolic blood pressure was lower than before and was better than the control group.3.During treatment,there was no statistically significant difference in the probability of adverse drug reactions and major adverse events between the two groups of patients.ConclusionCompared with ACEI(Ramipril),long-term application of ARNI(sacurabatril valsartan)can improve clinical performance,reduce plasma NT-pro BNP concentration,increase left ventricular ejection fraction,and reverse ventricular structure The long-term prognosis of patients with chronic heart failure is better;and the drug is relatively safe.