Early initiation of sacubitril/valsartan in STEMI patients improves ventricular remodeling

在STEMI患者中早期应用沙库巴曲/缬沙坦可改善心室重构

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Abstract

OBJECTIVE: To explore the effect of early administration (within 24 hours) of sacubitril/valsartan (Entresto) on left ventricular remodeling and prognosis in patients with ST-elevation myocardial infarction (STEMI). METHODS: A retrospective study was conducted involving 150 STEMI patients diagnosed at Jiangshan People's Hospital between September 2021 and August 2023. Among them, 70 patients who received sacubitril/valsartan treatment were assigned as the observation group, and 80 patients treated with valsartan formed the control group. The echocardiographic parameters and biomarkers of cardiac injury were assessed in both groups. RESULTS: The observation group exhibited improved left ventricular ejection fraction and reduced left atrial and ventricular diameters, along with a significant rise in stroke volume and reductions in left ventricular end-systolic and end-diastolic volumes. Cardiac injury biomarkers, including B-type natriuretic peptide and Troponin, significantly decreased in the observation group, while minimal changes were observed in the control group. Inflammatory markers, such as C-reactive protein, procalcitonin, and white blood cell count, were significantly reduced in the observation group. These findings underscore the efficacy of early sacubitril/valsartan treatment in improving outcomes for STEMI patients through enhanced ventricular function and reduced biomarkers of injury and inflammation. CONCLUSION: Early initiation of sacubitril/valsartan in STEMI patients significantly improves ventricular remodeling, as evidenced by enhanced echocardiographic parameters and reduced biomarkers, without increasing adverse events or compromising renal function.

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