Effects and Safety of Sacubitril/Valsartan for Patients with Myocardial Infarction: A Systematic Review and Meta-Analysis

Abstract

Patients who develop heart failure (HF) after an acute myocardial infarction (AMI) are at higher risk of adverse fatal and nonfatal outcomes. Studies have shown sacubitril/valsartan can further reduce the risk of cardiovascular death or hospitalization for heart failure by 20% compared with enalapril. At the same time, its tolerance and safety are better. However, the current evidence regarding the efficacy of sacubitril/valsartan in patients with heart failure after acute myocardial infarction is controversial. To assess the effect of sacubitril/valsartan on heart failure after acute myocardial infarction, we conducted a systematic review of the literature and a meta-analysis of existing randomized clinical trials. Meta-analysis of randomized controlled trails is used where data are collected from PubMed, the Cochrane library, Embase, and Web of Science. Data about sacubitril/valsartan were available from 5 studies. Forest plots showed that the sacubitril/valsartan group had a 299% higher value of sacubitril/valsartan to the control group (MD = 2.99%, 95% CI: 2.01, 3.96, I2 = 78%, P < 0.00001 , Figure 2), and the difference was statistically significant. Forest plots showed that the sacubitril/valsartan group had a 531% lower value of LVEF to the control group (MD = −5.31%, 95% CI: −7.36, −3.26, I2 = 91%, P < 0.00001 , Figure 2), and the difference was statistically significant. Forest plots showed that the sacubitril/valsartan group had a 133% lower value of NT-proBNP to the control group (MD = −1.33%, 95% CI: −1.54, −1.12, I2 = 96%, P < 0.00001 , Figure 3). Forest plots showed that the sacubitril/valsartan group had a 49% lower risk of heart failure to the control group (MD = 0.49, 95% CI: 0.27, 0.89, I2 = 0%, P = 0.02 , Figure 3). The patients in experimental showed an obviously lower OR of MACE (OR = 0.47, 95% CI: 0.27, 0.82, P = 0.007 , Figure 3). The data were statistically significant. We have observed that for patients with heart failure after acute myocardial infarction, early administration of sacubitril/valsartan can significantly reduce the incidence of heart rate, left ventricular ejection fraction, NT-proBNP, and MACE. Our meta-analysis suggests that taking sacubitril/valsartan is relatively safe and effective, especially if started early after acute myocardial infarction.

Circulating mir-483-5p as a novel diagnostic biomarker for acute coronary syndrome and its predictive value for the clinical outcome after PCI

“…ACS commonly arises from the rupture or erosion of atherosclerotic plaques in the coronary arteries that supply blood to the heart, resulting in arterial thrombosis and subsequent myocardial ischemia. This is primarily manifested as acute myocardial infarction (AMI) and unstable angina pectoris (UAP) [ 3 ]. As a significant burden on global healthcare, ACS has an urgent attack, rapid illness, and heavy mortality rate, and earlier diagnosis and detection can help provide timely management measures for ACS patients [ 4 ].…”

Comparison of Efficacy and Safety of Sacubitril/Valsartan and Perindopril in Acute Myocardial Infarction Complicated by Post Surgery Heart Failure

“…This suggested that sacubitril/ valsartan exerted a good effect on myocardial structure and ejection function, and its remodeling effect was superior to perindopril. This may be due to the inhibitory effect of sacubitril on neprilysin, which cooperates with valsartan to boost myocardial remodeling [26] . Additionally, Zhang et al [27] research has uncovered that sacubitril/valsartan can limit myocardial cell hypertrophy (including the border zone) and interstitial fibrosis, while increasing The observation group also displayed higher KCCQ scores and better clinical efficacy in contrast to the control group.…”

Retracted: Effects and Safety of Sacubitril/Valsartan for Patients with Myocardial Infarction: A Systematic Review and Meta-Analysis

“…This article has been retracted by Hindawi, as publisher, following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of systematic manipulation of the publication and peer-review process.…”