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The Value of Sacubitril/Valsartan in Acute Anterior Wall ST-Segment Elevation Myocardial Infarction before Emergency

Guoli Lin1, Wen Chen1, Meifang Wu1

  • 1Department of Cardiology, The Affiliated Hospital of Putian University, Putian University, Putian, China.

Cardiology
|October 5, 2022
PubMed

Insights

Preprocedural sacubitril/valsartan significantly improved left ventricular ejection fraction (LVEF) and lowered N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) in patients with acute anterior ST-segment elevation myocardial infarction (STEMI). This offers a promising treatment strategy for heart failure post-myocardial infarction.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Acute anterior ST-segment elevation myocardial infarction (STEMI) frequently leads to heart failure with reduced ejection fraction (HFrEF).
  • Optimizing early treatment is crucial for improving outcomes in STEMI patients.

Purpose of the Study:

  • To assess the impact of preprocedural sacubitril/valsartan on NT-pro-BNP and LVEF.
  • To evaluate sacubitril/valsartan's efficacy in acute anterior STEMI patients undergoing percutaneous coronary intervention (PCI).

Main Methods:

  • Randomized controlled trial involving 109 patients with acute anterior STEMI undergoing emergency PCI.
  • Patients received either sacubitril/valsartan or valsartan prior to PCI.
  • Primary endpoints: changes in NT-pro-BNP, LVEF, and heart failure rehospitalization.

Main Results:

  • Sacubitril/valsartan group showed a significantly greater decrease in NT-pro-BNP compared to the valsartan group.
  • LVEF significantly increased in the sacubitril/valsartan group versus the valsartan group.
  • The study included 55 patients in the sacubitril/valsartan arm and 54 in the valsartan arm.

Conclusions:

  • Preprocedural sacubitril/valsartan therapy improved LVEF and reduced NT-pro-BNP levels.
  • This suggests sacubitril/valsartan is a beneficial treatment for patients with acute anterior STEMI undergoing PCI.
  • Early initiation of sacubitril/valsartan may mitigate adverse cardiac remodeling and heart failure development.
Abstract

Keywords:
Heart failurePercutaneous coronary interventionST-segment elevation myocardial infarctionSacubitril/valsartan

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