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沙库巴曲缬沙坦在AMI患者PCI术后应用的有效性及安全性
引用本文:杨沛,任何,董爱巧,侯颖,王海燕.沙库巴曲缬沙坦在AMI患者PCI术后应用的有效性及安全性[J].心脏杂志,2021,33(6):585.
作者姓名:杨沛  任何  董爱巧  侯颖  王海燕
作者单位:1.心血管内科 空军军医大学唐都医院
摘    要: 目的 探索沙库巴曲缬沙坦在急性心肌梗死患者(AMI)经皮冠状动脉介入术(PCI)后应用的临床有效性及安全性。 方法 选取空军军医大学第二附属医院(2019年09月~2020年10月)收治的急性心肌梗死患者76例为研究对象,术后采用随机化分组将其分为缬沙坦治疗组(对照组,n = 38)和沙库巴曲缬沙坦治疗组(观察组,n = 38),治疗3 个月后对主要终点(心脏超声指标及MACE事件发生率等)、次要终点和安全性指标进行对比。 结果 与治疗前相比,观察组的左心房内径(LAd)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、血压、NT-proBNP指标降低(P<0.05);观察组LAd、LVEDV、LVESV的降低及抑制心室重构的效果优于对照组(P<0.05);与治疗前相比,两组患者 6 min步行距离均显著性变长(P<0.05),观察组较对照组距离增长更明显且具有统计学差异(P<0.05);两组患者用药的不良反应和主要不良心血管事件(MACE)发生率均无统计学差异。 结论 在急性心肌梗死患者术后抑制心室重构及预防心衰方面,沙库巴曲缬沙坦相比于缬沙坦表现更早且更有效,临床应用安全,为沙库巴曲缬沙坦在急性心肌梗死患者中的应用提供了临床依据。

关 键 词:沙库巴曲缬沙坦    急性心肌梗死    冠状动脉介入治疗    心功能
收稿时间:2021-03-18

Efficacy and safety of sacubitril valsartan following percutaneous coronary intervention for patients with acute myocardial infarction
Affiliation:1.Department of Cardiology2.Department of Ultrasound Diagnosis, Tangdu Hospital, Air Force Medical University, Xi’an 710038, Shaanxi, China
Abstract: AIM To explore the clinical efficacy and safety of sacubitril valsartan following percutaneous coronary intervention (PCI) for patients with acute myocardial infarction (AMI). METHODS Seventy-six patients with AMI admitted to the Second Affiliated Hospital of Air Force Medical University from September 2019 to October 2020 were selected as the study subjects. Postoperatively, they were assigned, using a block randomization, non-blind and positive-controlled method, to the valsartan treatment group (control group, n = 38) and sacubitril valsartan treatment group (observation group, n = 38). At 3 months of treatment, the primary endpoints including cardiac ultrasound indicators and incidence of major adverse cardiovascular events (MACEs), the secondary endpoints and the safety indicators were compared between the two groups. RESULTS Post-treatment left atrial diameter (LAd), left ventricular end diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), blood pressure and NT-proBNP showed statistically significant decreases from those pre-treatment in the observation group (P<0.05). The observation group was superior over the control group in reducing LAd, LVEDV and LVESV and inhibiting ventricular remodeling, with statistically significant differences (P<0.05). Post-treatment 6-minute walk distance (6MWD) showed statistically significant changes from that pre-treatment in both groups (P<0.05) and statistically significantly greater improvement in the observation group than that in the control group (P<0.05). There were no statistically significant differences between the two groups in the incidence of adverse drug reactions or MACEs. CONCLUSIONS For patients with AMI, sacubitril valsartan acts earlier and more efficaciously than valsartan in inhibiting ventricular remodeling and preventing heart failure, with favorable safety profile in clinical application, which provides clinical evidences for the application of sacubitril valsartan in patients with AMI. This conclusion requires to be further investigated in large studies.
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