Effects Of Sacubitril/Valsartan On Ventricular Remodeling And Cardiac Function In Patients Undergoing Emergency PCI After Acute Myocardial Infarction

Objective: Investigates the improvement of ventricular remodeling and cardiac function in patients with acute myocardial infarction(AMI)after emergency PCI with oral Sacubitril/Valsartan.Methods:This is a prospective,randomized,case-control research of 76 patients undergoing emergency PCI after acute myocardial infarction.They were randomly divided into experimental group(38cases)and control group(38cases).Patients on the basis of routine treatments such as anticoagulation,antiplatelet,lipid-lowering and plaque stabilization,ventricular rate control,acid inhibition and gastric mucosa protection,enalapril and Sacubitril/Valsartan were added respectively.Baseline data,myocardial infarction site and surgical data were compared between the two groups;Myocardial infarction markers(cTnI),NT-proBNP and renal function indicators(creatinine)were monitored during hospitalization;The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular mass index(LVMI)and other indicators were obtained by cardiac ultrasound examination immediately after PCI.Adverse drug reactions and adverse cardiac events were recorded during hospitalization and within 6 months of follow-up.Results: There was no statistical difference in baseline data between the two groups(P>0.05).There was no statistically significant difference between the experimental group and the control group in area of infarction and the blood flow of TIMI before and after interventional treatment(P>0.05).In serological examination,there was no statistical difference in cTnI between the two groups when were enrolled in the test(P>0.05).One week after PCI,the cTnI of the experimental group was significantly lower than that of the control group(P<0.05).Two weeks after PCI,the cTnI was no statistical difference between the two groups(P>0.05).).There was no statistical difference in the NT-proBNP,between the two groups when were enrolled in the test(P>0.05).The NT-proBNP level of the experimental group was significantly lower than that of the control group(P<0.05)at 3 months and 6 months after discharge.The levels of CREA in the experimental group at enrollment and 1、3 and 6 months after discharge were not statistically different from those in the control group(P>0.05).In cardiac ultrasound,there was no significant difference in LVEF,LVEDD and LVMI levels between the experimental group and the control group after PCI immediately(P>0.05).Results of LVEF,LVEDD and LVMI in the experimental group were better than those in the control group at 1、3 and 6 months after discharge(P< 0.05).The results of KCCQ score and 6-minute walking experiment(6MWT)in the experimental group and the control group were not statistically significant at 1 month after discharge(P > 0.05).The results of KCCQ scale score and 6-minute walking experiment in the experimental group were better than those of the control group(P< 0.05)at 3 and 6 months after discharge.There was no significant statistical difference in the incidence of cardiac adverse events and adverse reactions between the two groups(P> 0.05).Conclusion:Compared with enalapril,Sacubitril/Valsartan can significantly improve the cardiac function,obstruct ventricular remodeling,more curative effect on suppressing heart failure.Besides the incidence of cardiac adverse events and adverse reactions is lower.