| Objectives: There is still little evidence that angiotensin receptor enkephalin inhibitors have better effects on ventricular remodeling and prognosis in patients with acute non-ST-segment elevation myocardial infarction after emergency coronary intervention than angiotensin converting enzyme inhibitors.In this study,we investigated the effects of sacubitril/valsartan and perindopril on ventricular remodeling and long-term prognosis in non-ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention emergency,and further provided new ideas for clinical treatment of these patients..Methods: A total of 160 cases of non-ST-segment elevation myocardial infarction patients who underwent percutaneous coronary intervention emergency in our hospital during 2018-2022 were selected,of which 80 patients were treated with sacubitril/valsartan and valsartan on the basis of standardized treatment(treatment group)another 80 cases were treated with perindopril on the basis of standardized treatment(control group).Biochemical indicators such as N-terminal B-type natriuretic peptide and human soluble growth stimulation were detected before and after treatment in the two groups of patients,and cardiac ultrasound and cardiac magnetic resonance examination were conducted to compare the biochemical indicators and imaging differences of ventricular remodeling in the two groups of patients before and after treatment.Results: 1.Comparison of general data between sacubitril/valsartan group and angiotensin converting enzyme inhibitors group: there were no significant differences in gender,age,BMI,glutamic oxaloacetic transaminase,alanine transaminase,blood urea nitrogen,creatinine,uric acid,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol and drug use between the two groups.2.Comparison of biochemical indexes,cardiac ultrasound and cardiac magnetic resonance parameters between the sacubitril/valsartan group and the angiotensin converting enzyme inhibitors group:after 6 months of treatment in the sacubitril/valsartan group compared with before treatment,biochemical indexes Nterminal B-type natriuretic peptide,human soluble growth stimulation,cardiac ultrasound parameters left ventricular ejection fraction,left atrium diameter,1eft ventricular end diastolic diameter,left ventricular end systolic diameter,Cardiac magnetic resonance parameters left ventricular ejection fraction,1eft ventricular end diastolic diameter,left ventricular end systolic diameter,left ventricular mass,cardiac output,cardiac index and other indicators were statistically different(P<0.05).Compared with angiotensin converting enzyme inhibitors group,the above indexes were statistically different(P<0.05).3.Comparison between sacubitril/valsartan group and angiotensin converting enzyme inhibitors group: The incidence of major adverse cardiovascular events in sacubitril/valsartan group was lower than that in angiotensin converting enzyme inhibitors group,and the difference was not statistically significant(P=0.162>0.05).The incidence of adverse events in sacubitril/valsartan group was higher than that in angiotensin converting enzyme inhibitors group,but there was no statistical difference(P=0.548>0.05).Conclusions: 1.Both sacubitril/valsartan and angiotensin converting enzyme inhibitors can improve ventricular remodeling in non-ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention emergency,and the effect of improving ventricular remodeling is more obvious with the extension of treatment time.2.Sacubitril/valsartan has a better effect on left ventricular remodeling and prognosis in non-ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention emergency than angiotensin converting enzyme inhibitors. |
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