Comparison Study Of Chronic Heart Failure Patient With Angiotensin Receptor Neprilysin Inhibitor(ARNI) Vs Angiotensin Converting Enzyme Inhibitor(ACEI)

Objective:To determine,interpret and analyze efficacy,superiority and safety of using Angiotensin receptor neprilysin inhibitor（ARNI）Sacubitril Valsartan,Beta blockers and Anti-aldosterone as compared to ACE-inhibitor,Beta blockers and Anti-aldosterone in chronic heart failure due to reduced ejection fraction（EF）.Methods:A prospective study was conducted on patients with chronic heart failure who were hospitalized at Second Affiliated Hospital of Kunming Medical University,Yunnan province,P.R.China.It was done under the period of August 2019 to January 2020.There were about 49patients included in the study.Diagnosis of CHF was clinical and based upon typical HF symptoms accompanied by HF signs caused by a structural and/or functional cardiac abnormality.After diagnosis of chronic heart failure,all patients received standard treatment(1^stgroup（ARNI）Sacubitril valsartan,beta blockers and anti-aldosterone and 2^ndgroup（ACEI）with ACE inhibitor,Beta blockers,Anti-aldosterone)and undergoing cardiac echocardiography.Information including age,sex,signs and symptoms of disease,echocardiography,laboratory findings and cardiac biomarkers were recorded.Results:The study was performed on 49 patients（29 male and 20 females）with chronic heart failure.Mean age of male and female subjects was 68.52（±13.684）years and 72.70（±9.342）years but mean age was not statistically significant（t（47）=-1.272,p-value=0.21）.Similarly the Mean age of 1^stgroup cases and 2^ndgroup cases was 70.4（±10.767）years and 70.1（±13.235）years,the mean age was not statistically significant（t（47）=0.083,p-value=0.934）.The difference between male and female population was not associated to the treatment groupsχ²（1）=2.814,p-value=0.093;Fisher’s exact p-value=0.14.Also,the difference in mean temperature was not statistically significant in these groups as seen in independent samples t-test（t（47）=-0.887,p-value=0.38）.Mean pulse rate of 1st group cases and 2^ndgroup cases was 81.55（±22.8）per minute and 81.41（±21.196）,p-value=0.983 which is not statistically significant.Mean days of hospital stay of 1^stgroup cases and 2^ndgroup cases was 7.4（±1.93）days and 8.07（±2.267）days.The difference in mean days of hospital stay was not statistically significant（p-value=0.287）.Similarly,The difference in Mean respiratory rate（p-value=0.601）,systolic blood pressure（p-value=0.549）,diastolic blood pressure（p-value=0.801）,Weight（p-value=0.354）,Urea（p-Value=0.268）,Creatinine（p-value=0.81）,AST（p-value=0.087）,ALT（p-value=0.228）,EF%at admission（p-value=0.958）,MYO at Admission（p-value=0.734）,hs-TNT at admission（p-value=0.312）,CK-MB at admission（p-value=0.445）was not statistically significant.Whereas the difference in mean NT-Pro BNP at admission（p-value=0.03）,LDH（p-Value=0.036）was statistically significant.The difference between diabetic and non-diabetic population,Hypertension and non-hypertensive population,Dyslipidemia and non-dyslipidemia population,dyspnea and non-dyspnea population,edema,tachycardia,ECG findings,NYHA class at admission was not associated to the treatment.Conclusions:Result shows that,on a group of similar population characteristics like age,sex,clinical history and baseline investigation findings,with Sacubitril valsartan,Beta blockers and Anti-aldosterone is more effective as compared to ACE-inhibitor,Beta blockers and anti-aldosterone in terms of improvement in ejection fraction,MYO,hs-TNT,and CK-MB.Better result was seen in decreasing NT-pro BNP with Sacubitril Valsartan,Beta blockers and anti-aldosterone then the treatment with Ace-inhibitor,Beta blockers and Anti-Aldosterone.