| Objective: To study the changes of TN-C,YKL-40,s ST2 and cardiac function in patients with acute anterior wall myocardial infarction(AMI)before and after emergency PCI,to further understand the prognosis of patients,and to provide the clinical treatment of heart failure after acute myocardial infarction(AMI)with technical guidance and evidence of clinical data.Methods: Choose one hundred and ten patients with acute anterior wall myocardial infarction scheduled for emergency PCI in the Department of Cardiology of the first Hospital of Handan City from October 2019 to October 2020 were randomly divided into two groups with 55 patients in each group on the basis of antiplatelet therapy and Attovastatin calcium tablets,and oral administration of low dose of Sacubitril/Valsartan 25 mg bid or Enalapril 5mg qd was given as soon as possible after the postoperative hemodynamics was stable.Adjust the dose every 2weeks,gradually adjust the dose to the target dose or the maximum tolerable dose of Sacubitril/Valsartan(200mg bid)or Enalapril(20mg qd)and join the group accordingly.Venous blood samples were collected,and then the serum was collected after high-speed centrifugation.The levels of serum TN-C,YKL-40,s ST2 were determined by enzyme-linked immunosorbent assay(ELISA)before operation,on the 7th day after operation,and at the 1st and 3rd month after operation.The left ventricular ejection fraction((LVEF))of the two groups before operation,the 7th day after operation,and the 1st and 3rd month after operation were calculated and compared by biplane Simpson method by two deputy chief physicians in the ultrasound room of the first hospital.Results:(1)On admission,the levels of TN-C,YKL-40,s ST2 were higher and LVEF was lower in the two groups.(2)After treatment in different groups,the levels of TN-C,YKL-40 and s ST2 in the two groups decreased significantly on the 7th day,the first month and the third month after operation,and the decrease degree in the Sacubitril/Valsartan group was more obvious than that in the Enalapril group,and the difference was statistically significant(P<0.05).(3)The LVEF of the two groups at the first and third month was significantly higher than that at admission,and the improvement of LVEF in the Sacubitril/Valsartan group was more obvious than that in the Enalapril group,and the difference was statistically significant(P<0.05).Conclusion: The increase of LVEF during admission and postoperative follow-up directly showed the improvement of cardiac function,and the improvement of ejection fraction was more obvious in Sacubitril/Valsartan group than in Enalapril group.Compared with Enalapril,the levels of TN-C,YKL-40,s ST2 decreased significantly at the 7th day,1 month and 3 months after treatment,which further indicated that Sacubitril/Valsartan had a better effect on improving cardiac function and prognosis than Enalapril.This study provides a certain basis and evidence for the clinical application of Sacubitril/Valsartan in the treatment of heart failure after acute myocardial infarction. |
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