Effect of Sacubitril/Valsartan for alleviating chronic heart failure in elderly patients after acute myocardial infarction / 中华老年医学杂志

ABSTRACT

Objective To evaluate the effect of Sacubitril/Valsartan for alleviating chronic heart failure(CHF)in elderly patients after acute myocardial infarction(AMI).Methods A total of 87 elderly patients with AMI-induced CHF treated in Heze Shili Hospital from October 2017 to August 2018 were enrolled and randomly divided into the experimental group(n=42)and the control group(n =45).All patients were given standard AMI treatments,and patients in the experimental group were given Sacubitril/Valsartan (100 mg bid)while those in the control group received Valsartan (80 mg qd).After a follow-up of 12 months,levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular end-diastolic diameter(LVDd),left ventricular ejection fraction(LVEF),rates of rehospitalization for heart failure and all-cause mortality were compared between the two groups.Results Among the 87 patients,51 patients(58.6％)were male and 36 were female,with an averageage of(67.4 ± 4.0) years.After 12-months of treatment,patients in the experimental group were associated with significantly lower levels of LVDd[(47.86±3.86)mm vs.(50.73±4.39)mm,P＜0.05]and NT-proBNP [(793.43 ± 335.43) ng/L vs.(1 068.44 ± 344.46) ng/L,P ＜ 0.05] and higher levels of LVEF[(53.74 ± 4.08) ％ vs.(44.42 ± 7.41) ％,P ＜ 0.05] than those in the control group.Moreover,the rehospitalization rate for heart failure was markedly higher in the control group than that in the experimental group[15(33.3％)vs.5(11.9％),P＜0.05],while the rate of all-cause mortality was similar between the two groups[2 (4.8％)vs.3(6.7％),P =0.703].Conclusions Compared with Valsartan,Sacubitril/Valsartan can reduce the incidence of CHF after AMI,improve left ventricular function,and reduce the rehospitalization rate due to CHF in elderly patients.