Effect Of Sacubitril-Valsartan On Chronic Cardiac Insufficiency Caused By Coronary Heart Disease

Background and objective: Although coronary atherosclerotic heart disease is the important primary cause and risk factor of chronic cardiac insufficiency.,the current research is limited on cardiac insufficiency caused by coronary heart disease.As a common cardiovascular disease,explore its effective treatment approaches and methods are of great significance.Sacubitril-valsartan as a new development drug and Ⅰ class recommendation in the treatment guid of heart failure,the clinical curative effect is remarkable.But the new drug has little experience in treating chronic heart failure caused by coronary heart disease.The purpose of this study was to observe and compare the changes of cardiac function and other related indicators of treatment with sacubitril-valsartan and valsartan in patients with heart failure caused by CHD,and to evaluate the clinical efficacy of sacubitril-valsartan in patients with CHD induced heart failure,To seek better treatment for patients with coronary heart disease complicated with chronic cardiac insufficiency.Methods: A total of 50 patients with chronic heart failure caused by coronary heart disease who were hospitalized in our hospital from September 2019 to November 2020 were selected and randomized.They were numbered according to the order of visits and assigned to the experimental group and the control group with single number and double number respectively.Each group had 25 patients.Both groups received routine treatment of CHD and HF,including cardiac tonic,diuretic,expand the coronary artery,regulate blood lipid,inhibit platelet aggregation therapy,etc.On this basis,the experimental group was added with valsartan sodium(oral,target dose 200 mg BID),and the control group was added with Valsartan capsule(oral,target dose 160 mg QD).After 3 months,analyzing and comparing the changes in left ventricular diameter(LVd),left atrial diameter(LAd),left ventricular ejection fraction(LVEF),interventricular septal thickness(IVST),NT-proBNP,6MWT,and KCCQ scores between the two groups.The incidence of adverse reactions during and the rate of rehospitalization within 3 months were compared between the two groups.Results: After 3 months of treatment,1 of the 25 patients in the experimental group was discharged from the trial due to hypotension.A total of 24 patients completed the trial.In the control group,2 patients were lost to follow-up.A total of 23 patients completed the experiment.The left ventricular ejection fraction(LVEF),NT-proBNP,6-minute walking test and KCCQ score in the experimental group were significantly improved compared with the valsartan group(p < 0.05),and there was no significant difference in left ventricular dimension,left atrial diameter,interventricular septum thickness and adverse reaction incidence between the two groups(p > 0.05).Conclusion: Compared with traditional treatment,sacubitril-valsartan can effectively relief the clinical symptoms of heart failure caused by coronary heart disease,and do not increase the incidence of adverse reactions...