| Objectives To investigate the effect of Sacubitril /Valsartan on cardiac function in patients with chronic heart failure combined with type 2 diabetes.Methods 80 patients with chronic heart failure combined with type 2 diabetes who were hospitalized in the Department of Cardiovascular Medicine of Hebei General Hospital from June 2018 to June 2019 were selected and randomly divided into perimental group and control group.The two groups of patients were given anti-heart failure and hypoglycemic conventional treatments according to the treatment principles.Patients in the perimental group were Sacubitril /Valsartan(Novacin,Beijing Novartis Pharmaceutical Co.,Ltd.)50 mg orally twice daily,and the dose was gradually adjusted according to the patient’s blood pressure tolerance level,and the dose was doubled once every 2 weeks until it reached up to the target dose of 200 mg twice daily or the maximum dose that the patient can tolerate(if the patient is being treated with ACEI or ARB,it needs to be converted to Sacubitril /Valsartan 36 hours after stopping ACEI or 24 hours after ARB);Patients in the control group were given perindopril tertbutylamine tablets(Shiweiya(Tianjin)Pharmaceutical Co.,Ltd.)1 mg(once 2 day),and the drug dose was adjusted in the same manner until the maximum target dose was 4mg(once 2 day)or the patients Maximum tolerable dose.Follow-up of patients with the main events at 1 and 3 months of Heart function :Nterminal pro brain natriuretic peptide NT-ProBNPLeft ventricle enddiastolic diameter(LVEDD)、Left ventricular ejection fraction(LVEF))and secondary endpoint events: follow-up of patients with MACCE events(non-fatal)at 3 months of medication Myocardial infarction,non-fatal stroke,revascularization of target blood vessels,recurrent chronic heart failure,cardiogenic death,and adverse events(hypotension,headache / dizziness,hyperkalemia,kidney Malfunction,etc.).Results During the 3 month follow up process,10% of the patients in the experimental group achieved the target dose of 200 mg of sacubatril valsartan sodium each time,2 times a day,and 35% of the patients achieved 100 mg of each time,daily 2 doses,the remaining 55% of the patients took the oral dosage of 50 mg of sacubatril valsartan sodium twice a day;The dosage of perindopril tertiary butylamine tablets of 23% of the control group reached 4mg each time 2 times a day;In 67% of patients,the dosage of perindopril tertiary butylamine tablets is 2mg each time,2 times a day;In another 10% of patients the perindopril tertiary butylamine tablets is 1mg each time,2 times a day.Experimental group: At 1 month of treatment: cardiac function,blood glucose control level and left ventricular end diastolic diameter were improved from baseline levels,the difference was statistically significant;At 3 months of treatment,the experimental group’s heart function and blood glucose control level and left ventricle end diastolic diameter was further improved than before,all of which had significant statistical significance(P<0.05);The patients in the control group: the left ventricular ejection fraction and end diastolic diameter during 1 month of treatment were improved compared with before treatment,the difference was statistically significant Significance(P<0.05);After 3months,the cardiac function was improved than before treatment,which had significant statistical significance(P<0.05);the cardiac functionand and FBG control level of the experimental group were significantly improved compared with the control group at 3 months of treatment,with statistical difference(P<0.05);There was no statistically significant difference in the occurrence of MACCE events and other adverse reactions at 3 months of treatment(P> 0.05);Conclusions For patients with chronic heart failure combined with type 2 diabetes,Sacubitril /Valsartan can improve cardiac function better than perindopril tert-butylamine tablets,and Sacubitril /Valsartan may help better Control changes in blood sugar levels.Figure[5];Table[6];Reference[123]. |
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