Effect Of Sacubitril And Valsartan On The Prognosis Of Patients With Acute Myocardial Infarction After Emergency PCI

[objective]:To explore the influence of sacubitril and valsartan on the prognosis of patients with acute myocardial infarction after emergency percutaneous coronary intervention(Percutaneous Coronary Intervention,PCI),and to provide certain information for the clinical use of patients with acute myocardial infarction after emergency PCI.Diagnosis and treatment ideas.[method]:Collected patients who were admitted to the Department of Cardiology,Ningxia Hui Autonomous Region People’s Hospital from October 2019 to May 2020 who were clearly diagnosed as acute myocardial infarction and undergoing emergency PCI,and were randomly divided into control group and observation group by random number table method.On the basis of conventional treatment drugs,the control group received enalapril 10 mg orally once a day,and the observation group received sacubitril and valsartan at an initial dose of 25 mg orally twice a day,gradually according to the patient’s blood pressure fluctuations and changes in condition Increase the dose until the target dose of 100 mg is reached twice a day.Observe and record the clinical and laboratory data of the patients,and follow up these patients for 6 months,compare the changes of color Doppler echocardiogram related indicators of the two groups before and after treatment,and record the cardiovascular adverse events within 6 months after the operation.Something happened.[result]:1.Enalapril group and sacubitril valsartan group of patients in the gender,age,body mass index(BMI)cardiac function classification(Kiliip classification),previous history of diabetes,previous history of hypertension,previous atrial fibrillation Medical history,smoking,drinking,syncope,dyspnea,blood creatinine,troponin,blood sugar,C-reactive protein(CRP),glycosylated hemoglobin,application of diuretics,application of β-blockers are all different No statistical significance(P>0.05).2.In the comparison of related indicators of color Doppler echocardiography,the patients were followed up for 6 months after the operation.As the treatment time was extended,the left ventricular end-diastolic inner diameter of the sacubitril and valsartan group and the enalapril group The anteroposterior diameter of the left atrium,the anteroposterior diameter of the right ventricle,the transverse diameter of the right atrium,and NT-proBNP all decreased,and the LVEF increased;and the end-diastolic diameter of the left ventricle and the anteroposterior left atrium in the sacubitril and valsartan group compared with enalapril Diameter,anteroposterior diameter of right ventricle,transverse diameter of right atrium,NT-proBNP decreased more significantly,LVEF increased more significantly,time and group differences were statistically significant(P<0.05),and there was no statistically significant difference in cross calculation(P>0.05),it cannot be ruled out that the time comparison affects the results of the comparison between groups.The pulmonary artery pressure of the patients in the sacubitril,valsartan group and enalapril group decreased with the extension of treatment time,and the difference in time was statistically significant(P<0.05),and there was no significant difference in the comparison between the groups and the interaction.(P>0.05).There were no significant differences in left ventricular end-systolic volume,left ventricular end-diastolic volume index time,inter-group and interactive comparison between the two groups of patients(P>0.05).3.Compared with the enalapril group,there were fewer adverse cardiovascular events in the sacubitril and valsartan group within 6 months of postoperative treatment,and the difference was statistically significant(P<0.05).[Coclusion]:1.Compared with enalapril,sacubatril and valsartan can significantly inhibit ventricular remodeling in patients with acute myocardial infarction after emergency PCI,effectively improve postoperative heart function and reduce the incidence of heart failure.2.Compared with enalapril,sacubatril and valsartan can significantly reduce the incidence of cardiovascular adverse events in patients with acute myocardial infarction after emergency PCI within 6 months,and improve the prognosis of patients.