Short-term Therapeutic Effect Of Shakubatro/valsartan On Post-AMI Heart Failure

Objective: 2021 Journal of the American College of Cardiology published LCZ696 as a Class A drug recommendation for the treatment of patients with HFREFⅠ.However,its use in the treatment of HF patients after AMI has not been included in the recommended guidelines at home and abroad.This study prospectively observed the changes of cardiac function and other indexes in patients with heart failure(HF)after taking LCZ696 after acute myocardial infarction(AMI),and explored the efficacy of LCZ696 in the treatment of HF patients after AMI,so as to provide more evidence-based medical evidence for the clinical treatment of such patients.Methods: A total of 63 hospitalized patients with heart failure after acute myocardial infarction diagnosed in the Department of Cardiology of Xiangxi Autonomous Prefecture People’s Hospital Hospital from January 2019 to December2020 were selected.On the basis of conventional MI drugs after PCI,the observation group was given Shaqubatrovalsartan sodium tablet and the control group was given Enalapril maleate tablet.Respectively in 30(thirty)days from day 1,hospital admission and discharge the 90 th day collecting venous blood,detecting the NT-pro BNP,serum potassium ion concentration(K +),creatinine(Scr),urea(UA),alanine aminotransferase(ALT),aspartate aminotransferase(AST),measuring 6minutes walk test(6 MWT),and records the walking distance,blood pressure(BP)and heart rate(HR);Cardiac function classification(NYHA)results were assessed and recorded.Tranthoracic Doppler echocardiography was completed and parameter values(LVEF,LVEDD,LVESD)were recorded.Adverse reactions and major cardiovascular adverse events within 90 days after discharge were recorded and the clinical efficacy was evaluated.Results:During the follow-up period,all of the 31 patients in the observation group completed the trial,2 patients were hospitalized again due to heart failure,and3 patients developed asymptomatic hypotension,and their blood pressure was controlled within the normal range after adjusting the oral dose of shakubactrovalsartan sodium tablet.Of the 32 patients in the control group,30 patients completed the trial,among which 2 patients failed to complete the trial due to significantly increased creatinine value during the follow-up period,5 patients were hospitalized again due to heart failure,and 2 patients developed dry cough symptoms.Enalapril maleate tablets were discontinued and changed to oral valsartan for further treatment.(1)After 30 days of treatment,NT-pro BNP wasdecreased in the observation group compared with the control group(P < 0.001),and LVEDD was improved(P< 0.05);(2)After 90 days of treatment,LVEF and LVESD indices were improved between groups(P < 0.05);Blood pressure and SCR were decreased(P < 0.05);The improvement of NAYH distribution and 6MWT was better than that of the control group(P < 0.05).(3)After 90 days of treatment,there were no statistically significant differences in total effective rate and MACE incidence between the two groups(P =0.087;P = 0.396).Conclusion:Compared with enalapri maleate tablets,shakupactr-valsartan sodium tablets can reverse ventricular remodeling,improve cardiac function and improve the quality of life of patients with HF after short-term medication after acute myocardial infarction,without increasing the incidence of adverse reactions and recent MACE events.