Efficacy and safety of sacubitril-valsartan in patients with heart failure: a systematic review and meta-analysis of randomized clinical trials: A PRISMA-compliant article.

BACKGROUND: To investigate the efficacy and safety of sacubitril-valsartan in patients with heart failure, relevant randomized clinical trials (RCTs) were analyzed. METHODS: We used Cochrane Library, PubMed web of science, CNKI, VIP, Medline, ISI Web of Science, CBMdisc, and Wanfang database to conduct a systematic literature research. A fixed-effects model was used to evaluate the standardized mean differences (SMDs) with 95% confidence intervals. We conducted sensitivity analysis and analyzed publication bias to comprehensively estimate the efficacy and safety of sacubitril-valsartan in patients with heart failure. RESULTS: Among 132 retrieved studies, 5 relevant RCTs were included in the meta-analysis. The result showed that left ventricular ejection fraction (LVEF) was improved after sacubitril-valsartan in patients with heart failure, with an SMD (95% CI of 1.1 [1.01, 1.19] and P < .00001 fixed-effects model). Combined outcome indicators showed that, combined outcome indicators showed that, compared with control group, the left ventricular volume index (LAVI) (WMD = -2.18, 95% CI [-3.63, -0.74], P = .003), the E/e' (WMD = -1.01, 95% CI [-1.89, -0.12], P = .03), the cardiovascular death (RR = 0.89, 95% CI [0.83, 0.96], P = .003], and the rehospitalization rate of heart failure (RR = 0.83, 95% CI [0.78, 0.88], P < .01) decreased more significantly, but it had no effect on renal function (WMD = 0.74, 95% CI [0.54, 1.01], P = .06). CONCLUSIONS: The present meta-analysis suggested that sacubitril-valsartan may improve the cardiac function of heart failure. Given the limited number of included studies, additional large sample-size RCTs are required to determine the long-term effect of cardiac function of sacubitril-valsartan in patients with heart failure.

Functional analysis of ceRNA network of lncRNA TSIX/miR-34a-5p/RBP2 in acute myocardial infarction based on GEO database.

The identification of innovative gene biomarkers with clinical efficacy is warranted for the treatment of acute myocardial infarction (AMI). The current study sought to screen potential target genes in AMI via bioinformatic analysis and analyze their effects on cardiomyocyte apoptosis. The differentially expressed long non-coding RNAs (lncRNAs) of AMI were screened, and the downstream microRNAs (miRNAs) and mRNAs of lncRNA antisense for X-inactive-specific transcript (lncRNA TSIX) were predicted accordingly. The diagnostic relationship between the 12 differentially expressed lncRNAs and AMI was analyzed by receiver operating characteristic (ROC). Next, the expressions of 12 lncRNAs, including miR-34a-5p and retinol binding protein 2 (RBP2) were all detected. The targeting relationships of miR-34a-5p with lncRNA TSIX and RBP2 were verified. AMI model was established and treated with Ad-TSIX and/or agomiR-34a-5p to evaluate the cardiac function and cardiomyocyte apoptosis of AMI mice. LncRNA TSIX was identified as the most differentially expressed lncRNA in AMI. Our findings revealed that LncRNA TSIX could function as an AMI diagnostic marker. LncRNA TSIX could target miR-34a-5p and miR-34a-5p could target RBP2. Upregulation of lncRNA TSIX could ameliorate cardiac injury inflicted by AMI and mitigate cardiomyocyte apoptosis. Upregulation of miR-34a-5p reversed the effect of lncRNA TSIX overexpression to ameliorate cardiomyocyte apoptosis in AMI mice. Overall, the overexpression of lncRNA TSIX inhibits cardiomyocyte apoptosis by competing with RBP2 to bind to miR-34a-5p and promoting RBP2.

[Peripheral blood apelin level in patients with acute ST-elevation myocardial infarction and its prognostic value].

OBJECTIVE: To investigate peripheral blood apelin levels in patients with acute ST-elevation myocardial infarction (STEMI) and their correlation with the one-year outcome of the patients. METHODS: A total of 153 consecutive patients, including 93 with acute STEMI undergoing primary percutaneous coronary intervention (PCI), 30 with acute STEMI and 30 with stable angina all undergoing elective PCI, and 10 healthy control subjects were examined for peripheral blood apelin levels and clinical parameters. The composite endpoints (CEPs) were determined at the one year follow-up. RESULTS: Apelin levels were significantly decreased in all the patients at admission, but increased following primary PCI. Apelin levels showed a negative correlation with glycosylated hemoglobin levels. At one year following PCI, the patients with a lower apelin level showed an increased risk for lowered left ventricular ejection fraction ratio, but further analysis failed to provide evidence that apelin levels were predictive of the one-year outcome. CONCLUSION: Peripheral blood apelin levels might be useful for predicting the clinical outcomes of patients with acute STEMI.