| ObjectiveBy observing the changes of ventricular remodeling indexes,the differences in the occurrence of major adverse cardiovascular events(MACEs)and common adverse reactions in patients with acute myocardial infarction(AMI)before and after treatment,the clinical efficacy and safety of sacubitril/valsartan compared with angiotensin converting enzyme inhibitor(ACEI)in the prevention and treatment of ventricular remodeling after AMI were compared.To seek more effective drugs for the prevention and treatment of ventricular remodeling after AMI,so as to better improve the prognosis of patients with AMI.MethodsAMI patients admitted to the Department of Cardiology of Gansu People’s Hospital from October 2018 to October 2020 who met the criteria were selected.Patients were divided into the control group and the sacubitril/valsartan(test)group according to the difference in treatment regimen.Totally,138 patients were eventually included.After admission,70 patients in the control group were given benazepril(10mg once a day)as soon as their condition allowed,together with other conventional treatment agents,68 patients in trial group were given sacubitril/valsartan(50mg twice a day)as soon as their condition allowed,together with other conventional therapy,according to the condition and adverse reactions to adjust doses.Baseline data of the patients were obtained by inquiring the general condition of the patients and recording the results of tests and examinations.After 3 months of treatment,patients’ serum N terminal patients with b-type natriuretic peptide(NT-proBNP)and echocardiography [left interior diameter(LVID),the thickness of interventricular septum(IVS),left ventricular posterior wall thickness(LVPW),left ventricular mass(LVM),left ventricular mass index(LVMI),left ventricular relative wall thickness(RWT),left ventricular ejection fraction(LVEF),left ventricular short axis shortening rate(FS),mitral valve mouth early and late diastolic blood flow ratio(E/A)] were reexamined,and the incidence of major adverse cardiac events(all because of death,heart failure,recurrence of angina pectoris,AMI,severe arrhythmia,etc.)and the common adverse reactions(low blood pressure,angioedema,hyperkalemia,renal impairment,etc.)during the treatment period was recorded.The levels of serum NT-proBNP,echocardiographic indicators,MACEs and common adverse reactions were compared between the two groups.ResultsThere were no significant differences in general information,baseline serum NT-proBNP level and echocardiographic indicators between the two groups(all P values were > 0.05).After treatment,NT-proBNP,LVEDd,LVIDs,IVSd,LVPWd,LVM and LVMI in the treatment group were lower than those in the control group,while LVEF and FS were higher than those in the control group,with statistical differences(all P values were < 0.05).There were no statistical differences in IVSs,LVPWs,E/A and RWT compared with the control group(all P values were > 0.05).The incidence of MACEs in the treatment group was lower than that in the control group,but the difference was not statistically significant(P > 0.05).There was no significant difference in the incidence of common adverse reactions between the two groups(P > 0.05).Conclusions1.Compared with ACEI,sacubitril/valsartan can improve most of the indicators related to ventricular remodeling in patients with AMI,and inhibit ventricular remodeling in patients more effectively.2.Compared with ACEI,sacubitril/valsartan can reduce the occurrence of major adverse cardiovascular events in patients with AMI and more effectively improve the short-term prognosis of patients.3.Compared with ACEI,sacubitril/valsartan does not increase the occurrence of common adverse reactions in patients with AMI,showing good safety. |
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