Title : Compaired sacubitril/valsartan with benalapril on the left ventricular remordeling of AMI after PPCI: A case-control study
Abstract:
Background: To compare the effect of sacubitril/valsartan with benalapril on left ventricular remodeling in patients with acute myocardial infarction.
Materials and Methods: 85 patients with acute ST segment elevation myocardial infarction who were treated with PCI in the Second Affiliated Hospital of Tianjin Medical University. The patients were randomly divided into two groups: The experimental group (sacubitril/valsartan, 25-100mg/d, BID) and the control group (benalapril, 5-10mg, QD). Color Doppler echocardiography was performed after 1 month and 3 months respectively, interventricular septal thickness, septal motion amplitude, left ventricular end diastolic diameter, left ventricular end systolic diameter, posterior wall thickness, posterior wall motion amplitude, LVEF, left ventricular weight, left ventricular weight index, NT Pro-BNP, gender, height, weight, body surface area were collected. In order to evaluate the influencing factors in the process of ventricular remodeling, binary multivariate logistic regression analysis was carried out for the indicators with statistical differences in the conclusions of the above control study. subgroup analysis was carried out and the samples were divided into four subgroups according to gender, age, initial ejection fraction.
Result: One month after the treatment of sacubitril/valsartan or benalapril, only the left ventricular end systolic diameter was statistically different between the two groups (P < 0.05), and the other indexes were not statistically different. three months after treatment with sacubitril/valsartan or benalapril, there were statistical differences in the indexes related to myocardial remodeling between the two groups (P < 0.05). The results of multivariate logistic analysis showed that the index of left ventricular end systolic diameter was statistically significant (or=0.006 , 95% CI: 0.733-0.981). Acute myocardial infarction whose LVEF is less than 50%, show sacubitril/valsartan is better than traditional ACEI.
Conclusion: Sacubitril/valsartan Compared with benalapril is better on left ventricular remodeling in patients with ST segment elevation acute myocardial infarction.
Key words: Sacubitril/Valsartan; Benalapril; Left Ventricular Remordeling; AMI; PPCI
