Effect Of Sarcubatrivalsartan On Lipid Metabolism In Patients With Cardiorenal Syndrome With Preserved Ejection Fraction

Objective:To explore the effect of Sacubitril Valsartan Sodium Tabletson lipid metabolism in patients with hypertension combined with left ventricular ejection fraction(LVEF)and cardiorenal syndrome(CRS),in order to further understand the therapeutic effect of Sacubitril Valsartan Sodium Tablets on blood lipids.Methods:The retrospective analysis method was used to select 200 patients with LVEF and CRS who were diagnosed by the Department of Cardiology of the Second Affiliated Hospital of Shenyang Medical College from August 2020 to August 22 for analysis.Among them,118 patients who were treated with Sacubitril Valsartan Sodium Tablets were included in the study group;In addition,82 patients who were not treated with Sacubitril Valsartan Sodium Tablets were included in the control group.The non-Nosithal group was treated with angiotensin converting enzyme inhibitor(ACEI)or angiotensin II receptor blocker(ARB).① Collect the general data,past history,blood lipid index,cardiac function index,renal function index,and the occurrence of adverse cardiovascular events(MACE)after 6 months at the time of treatment and after 6 months.General information includes age,sex,height,weight,blood pressure,heart rate,and NYHA cardiac function classification.The blood lipid index is triglyceride(TG),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C).Cardiac function indexes include N-terminal pro-brain natriuretic peptide(NT-pro BNP),left ventricular end-diastolic diameter(LVIDD),and LVEF.Renal function indicators include blood urea nitrogen(BUN),serum creatinine(SCR),and glomerular filtration rate(eGFR).Compare the above data,indicators and adverse cardiovascular events between the two groups.② According to the baseline level of triglyceride(TG),patients in the study group were divided into high baseline TG(≥2.2mmol/L)group and low baseline TG(<2.2mmol/L)group with the cut-off value of 2.2mmol/L.The corrected sex,LVEF and follow-up were the same.The improvement of TG,HDL-C and LDL-C in the two groups after 6 months of treatment were compared.③ After 6 months of follow-up,200 patients were divided into MACE group and non-MACE group according to the occurrence of MACE.The general data and biochemical indicators of the two groups were compared,and the related factors of MACE were analyzed by multivariate binary logistic regression analysis.Results:① There was no statistical difference between the study group and the control group in general data,past history,blood lipid index,cardiac function index and renal function index at the time of treatment(P>0.05);② After 6 months of treatment,TG in the study group was lower than that in the control group(P.The HDL-C of the study group was higher than that of the control group(P<0.05).The LDL-C of the study group was higher than that of the control group,with no statistical difference(P>0.05).In terms of cardiac function indexes,the levels of NT-pro BNP and LVIDD in the study group were lower than those in the control group(P<0.05).In terms of renal function,BUN,SCR and eGFR in the study group were not significantly different from those in the control group(P>0.05);③ The improvement of TG and HDL-C in the high baseline TG group after 6 months of treatment was significantly higher than that in the low baseline TG group(P<0.05).The improvement of LDL-C in the high baseline TG group was lower than that in the low baseline TG group,with no statistical difference(P>0.05).④ The incidence of MACE in the study group was significantly lower than that in the control group(P<0.05).There were 22 people in the MACE event,including 6 in the research group;There are 178 people in non-MACE group,including 112 in the research group.For the statistically significant variables in the univariate analysis,the multivariate binary logistic regression analysis was used.The improvement of TG,HDL-C,and whether to use sarcubatrixartan were the independent influencing factors of MACE in LVEF patients with CRS(P<0.05).Conclusion:①In the treatment of LVEF patients with CRS,the use of Sacubitril Valsartan Sodium Tablets can improve the lipid metabolism and enhance the effect on the improvement of patients’ cardiac function.② The improvement effect of cardiac function and blood-lipid related indexes of Sacubitril Valsartan Sodium Tablets is more obvious in patients with high baseline TG level.③The incidence of MACE can be reduced by the use of Sacubitril Valsartan Sodium Tablets.The improvement of TG,HDL-C and whether to use Sacubitril Valsartan Sodium Tablets are independent influencing factors for the occurrence of MACE in LVEF patients with CRS.