Short-term Efficacy Observation Of Sacubitril/Valsartan In Patients With 1-type Cardiorenal Syndrome

Objective: To compare the effect of Sacubitril /Valsartan and Perindopril tert-Butylamine Tablets on the prognosis of patients with1-type Cardiorenal syndrome.Methods: From January 2019 to January 2020,70 patients diagnosed with 1-type 1 type Cardiorenal syndrome were admitted to the Department of Cardiology,Hebei General Hospital.The patients were randomly divided into observation group and control group with 35 cases in each group.In the control group,the recommended standard drug therapy against heart failure was used,in which the ACEI drug was perindopril tert-butylamine tablets(Shiweiya,Tianjin Pharmaceutical Co.,LTD.)1mg(once 2 day),doubling the dose every 2 weeks until reaching the maximum drug dose of 4mg(once 2 day)or the maximum tolerated dose of the patient.In the observation group,the recommended standard drug therapy against heart failure was used,Sacubitril /Valsartan(Novacin,Beijing Novartis Pharmaceutical Co.,LTD.)was selected and started at 50mg(once 2 day).The dose was doubled every 2 weeks and titrated gradually to 200mg(once 2 day)or the patient’s maximum tolerated amount(if the patient is being treated with ACEI or ARB,it needs to be converted to Sacubitril /Valsartan 36 hours after stopping ACEI).The therapeutic effect and the occurrence of adverse reactions in the 2 groups were observed.The primary endpoints was the improvement of Nterminal pro brain natriuretic peptide(NT-proBNP),creatinine,eGFR and echocardiography parameters after 4 weeks and 12 weeks.Secondary endpoints were cardiovascular events such as all-cause death,heart failure,renal failure,myocardial infarction,and number of rehospitalizations for heart failure after 4 weeks and 12 weeks of administration.Adverse reactions(hypotension,hyperkalemia,angioedema,bradycardia,dizziness/headache,deterioration of liver and kidney function,etc.)were observed in the two groups.Results: Both sacubitril /valsartan and perindopril tert-butylamine tablets can improve cardiac function and inhibit ventricular remodeling to some extent,and the improvement was more obvious with sacubitril/valsartan.Both sacubitril /valsartan and perindopril tert-butylamine tablets can improve creatinine and eGFR levels to some extent,and the improvement was more obvious with sacubitril /valsartan.Both drugs improved urea nitrogen slightly,but the effect of sacubitril /valsartan was slightly stronger.There was no significant improvement in the effect of both drugs on uric acid.Both sacubitril /valsartan and perindopril tert-butylamine tablets have certain effects in improving cardiac function,while the sacubitril /valsartan group has a better 6MWT improvement,so there is a certain advantage.There was no difference in safety between sacubitril /valsartan and perindopril tert-butylamine tablets.Conclusions: Sacubitril /Valsartan can significantly improve the clinical prognosis of patients with 1-type Cardiorenal syndrome,and It has a protective effect on kidney function.The adverse reactions and cardiovascular events were equal to the control group.