Efficacy and safety of sacubitril valsartan in treating heart failure with midrange ejection fraction after acute myocardial infarction in diabetic patients

Ye, Fanhao; Li, Hebo; Chen, Xiaoshu; Wang, Yi; Lin, Wei; Chen, Hao; Huang, Shi‐Wei; Han, Sisi; Guan, Fanlu; Huang, Zhouqing

doi:10.1097/md.0000000000028729

Cited by 4 publications

(15 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The search identified 790 articles and 2 studies registered at Clinicaltrials.gov that met the inclusion criteria. After removing duplicates and screening, 9 studies ( 24 – 32 ) involving 1,369 participants were ultimately eligible for analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 9 studies, 6 were RCTs and 3 were non-RCTs. Based on our defined outcomes, 8 studies reported on CRR outcomes ( 24 , 25 , 27 – 32 ); 4 studies reported on biomarkers outcomes ( 25 , 29 – 31 ); 7 studies reported on MACE and HF outcomes ( 25 – 31 ); 6 studies reported on readmission outcomes ( 25 , 26 , 28 , 30 – 32 ); 4 studies reported on cardiac death outcomes ( 26 – 28 , 31 ); 4 studies reported on MI outcomes ( 26 – 29 ); while 3 studies reported on adverse side effects ( 25 , 28 , 30 ).…”

Section: Resultsmentioning

confidence: 99%

“…Summary data of the three studies ( 25 , 29 , 32 ) showed that left ventricular end-diastolic diameter (LVEDD) decreased significantly compared with baseline after treatment with ARNI (MD: –6.80 mm, [95%CI: –9.14, –4.46]; Figure 3B ). Subgroup analysis showed that LVEDD decrease significantly in different follow-up times (3, 6, and 12 months), respectively (MD: –5.36 mm, 95%CI: –7.48, –3.23; Figure 4B ), (MD: –7.98 mm, 95%CI: –8.99, –6.97; Figure 4B ) and (MD: –4.26 mm, 95%CI: –5.93, –2.59; Figure 4B ).…”

Section: Resultsmentioning

confidence: 99%

“…Pooled data involving 937 patients from 8 studies (24, 25, [27][28][29][30][31][32] showed that LVEF scores increased significantly compared with baseline after treatment with ARNI (MD: 9.02%, [95%CI: 6.68, 11.36]; Figure 3A). Nonetheless, the I 2 -value for studies assessing changes was 87%, implying significant heterogeneity across the studies.…”

Section: Effects Of Angiotensin-receptor Neprilysin Inhibitor On Card...mentioning

confidence: 99%

“…Summary data of the three studies (25, 29,32) showed that left ventricular end-diastolic diameter (LVEDD) decreased…”

Section: Left Ventricular End-diastolic Diametermentioning

confidence: 99%

See 4 more Smart Citations

Efficacy and safety of sacubitril/valsartan vs. valsartan in patients with acute myocardial infarction: A meta-analysis

Yang

Han²,

Lü³

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundThe angiotensin-receptor neprilysin inhibitor (ARNI) sacubitril/valsartan was shown to be superior to the angiotensin receptor blocker (ARB) valsartan in terms of reversing heart failure classification (NYHA classification), reducing N-terminal pro-brain natriuretic peptide (NT-proBNP) level and cardiovascular mortality in many studies. Yet, the efficacy of ARNI did not come from patients with acute myocardial infarction (AMI).MethodsWe searched databases for research published from inception to July 29, 2022, that reported cardiac reverse remodeling (CRR) or security indices. Two reviewers independently screened literature, extracted data, and assessed the risk of bias. Nine studies enrolling 1,369 patients were included to perform a meta-analysis. There were 716 patients in the ARNI group and 653 in the ARB group.ResultsARNI outperformed ARBs in terms of CRR indices, with striking changes in left ventricular ejection fraction (EF) (MD: 4.12%, 95%CI: 2.36, 5.88, P < 0.0001), diameter (MD: –3.40 mm, 95%CI: –4.30, –2.94, P < 0.00001, I2 = 0%) and left atrial diameter (MD: –2.41 mm, 95%CI: –3.85, –0.97, P = 0.001, I2 = 0%), other indices there showed no significant improvements. The incidences of major adverse cardiac events (RR: 0.47, 95%CI: 0.34–0.65, P < 0.00001, I2 = 0%), the heart failure (RR: 0.37, 95%CI: 0.23–0.61, P < 0.0001, I2 = 0%), readmission (RR: 0.54, 95%CI: 0.36–0.80, P = 0.003, I2 = 29%) in the sacubitril/valsartan group were lower than the ARB group, while the incidences of cardiac death (RR: 0.56, 95%CI: 0.28, 1.09, P = 0.09), the myocardial infarction (RR: 0.83, 95% CI: 0.39, 1.77, P = 0.63), adverse side effects (RR: 1.67, 95% CI: 0.89, 3.13, P = 0.11) showed no difference.ConclusionThis research indicated that early initiation of sacubitril/valsartan in patients after AMI was superior to ARBs in reducing the risks of major adverse cardiac events, heart failure, readmission, and enhancing left ventricular EF, decreasing diameter, left atrial diameter. As for the other outcomes (the incidences of cardiac death, myocardial infarction, and adverse side effects), sacubitril/valsartan demonstrated no obvious advantage over ARBs.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier [CRD42022307237].

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Effects Of Angiotensin-receptor Neprilysin Inhibitor On Card...mentioning

confidence: 99%

“…Summary data of the three studies (25, 29,32) showed that left ventricular end-diastolic diameter (LVEDD) decreased…”

Section: Left Ventricular End-diastolic Diametermentioning

confidence: 99%

See 3 more Smart Citations

Efficacy and safety of sacubitril/valsartan vs. valsartan in patients with acute myocardial infarction: A meta-analysis

Yang

Han²,

Lü³

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

Protective Effects of Ultrasound-Based Preoperative Exogenous Sacubitril/Valsartan on the Heart and Kidney of Patients Undergoing Percutaneous Coronary Intervention

WANG

2023

FARMACIA

View full text Add to dashboard Cite

This research aimed to demonstrate the protective effects of exogenous sacubitril/valsartan on the heart and kidney of patients undergoing percutaneous coronary intervention (PCI) preoperatively based on ultrasound. Three hundred patients undergoing PCI in our hospital were assigned to a control (Ctrl) group (150 patients receiving valsartan preoperatively) and a research (Res) group (150 patients receiving sacubitril/valsartan preoperatively). The myocardial injury, cardiac function (CF), renal function (RF) and complications of the two groups were compared preoperatively and postoperatively. The results showed that the troponin I (cTnI) and creatine kinase isoenzyme myocardial bands (CK-MB) in the two groups showed a decreasing trend postoperatively, and that of the Res group was more significant (p < 0.05). Postoperatively, the left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) of the two groups of patients decreased, being more significant in the Res group (p < 0.05). Postoperatively, blood urea nitrogen (BUN) and creatinine (Cr) in the two groups were decreased, the trend being more evident in the Res group (p < 0.05). The drug efficiency in the Ctrl group and Res group was 84.67% and 93.33%, respectively, and the effective rate of drugs in the Res group was y higher (p < 0.05). In summary, ultrasonography had a positive adoption value in evaluating the treatment effect of coronary intervention, and exogenous sacubitril/valsartan had an important protective effect on the heart and kidneys of patients undergoing PCI. RezumatÎn cadrul acestui studiu au fost investigate efectele protectoare exogene ale sacubitril/valsartan asupra inimii și rinichilor la pacienții supuși intervenției coronariene percutanate (ICP), preoperator, pe baza ecografiei. Un număr de trei sute de pacienți supuși ICP au fost repartizați astfel: un grup de control (Ctrl) (150 de pacienți care au primit valsartan preoperator) și un grup de cercetare (Res) (150 de pacienți care au primit sacubitril/valsartan preoperator). Leziunea miocardică, funcția cardiacă (FC), funcția renală (RF) și complicațiile celor două grupuri au fost comparate preoperator și postoperator. Rezultatele au arătat că benzile miocardice ale troponinei I și ale izoenzimei creatin kinaza în cele două loturi au prezentat o tendință de scădere postoperator, cea din grupul Res fiind mai semnificativă (p < 0,05). Postoperator, volumele telediastolic și telesistolic ale ventriculului stâng din cele două loturi de pacienți au scăzut, fiind mai semnificative în grupul Res (p < 0,05). Postoperator, porțiunea azotată a ureei din sânge și creatinina au fost scăzute în cele două loturi, tendința fiind mai evidentă în grupul Res (p < 0,05). Eficiența medicamentelor în grupul Ctrl și grupul Res a fost de 84,67%, respectiv 93,33%. În concluzie, în urma evaluării prin ultrasonografie, asocierea sacubitril/valsartan a dovedit o protecție importantă asupra inimii și rinichilor la pacienții care au suferit IPC.

show abstract

A systematic review and meta-analysis of sacubitril-valsartan in the treatment of ventricular remodeling in patients with heart failure after acute myocardial infarction

Zhou

Zhu²,

Zheng³

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

ObjectiveTo systematically review the efficacy and safety of sacubitril and valsartan in treating acute myocardial infarction complicated with heart failure and to observe whether it can further improve patients’ cardiac function, delay left ventricular remodeling, and reduce major adverse cardiovascular events (MACEs).MethodsElectronic databases including Pubmed, Embase, the Web of Science, Cochrane Library, Scopus, CNKI, Wanfang Data, and VIP were searched. The search period was from the establishment of the database to March 2022 to search for relevant controlled trials. Two investigators independently screened the literature, extracted data, and assessed the risk of bias. Revman5.3 and Stata14 software were used for statistical analysis.ResultsA total of 13 studies, with 6,968 patients were included. Meta-analysis results showed that sacubitril-valsartan increased left ventricular ejection fraction (LVEF) and decreased NT-proBNP level was better at 6 months and within 3 months of follow-up compared with the control group (P < 0.00001), but there was no significant difference at the 12-month follow-up (P > 0.05). Sacubitril-valsartan reducing LVEDD [MD = −2.55, 95%CI(−3.21, −1.88), P < 0.00001], LVEDVI [MD = −3.61, 95%CI(−6.82, −0.39), P = 0.03], LVESVI [MD = −3.77, 95%CI(−6.05, −1.49), P = 0.001], and increasing the distance of the 6-min walk test [MD = 48.20, 95%CI(40.31, 56.09), P < 0.00001] were more effective. Compared with ACEI/ARB, the use of ARNI can further reduce the total incidence of adverse cardiovascular events [RR = 0.72, 95%CI(0.62, 0.84), P<0.0001] and the rate of HF rehospitalization [RR = 0.73, 95%CI(0.61, 0.86), P = 0.0002] in patients with acute myocardial infarction and heart failure; there was no significant difference in the incidence of cardiac death, recurrence of myocardial infarction, and malignant arrhythmia between the experimental group and the control group (P > 0.05). In terms of the incidence of adverse reactions, the incidence of cough in ARNI was lower than that in ACEI/ARB group [RR = 0.69, 95%CI(0.60, 0.80), P < 0.00001], but the incidence of hypotension was higher [RR = 1.29, 95%CI(1.18, 1.41), P < 0.00001], and the adverse reactions of hyperkalemia, angioedema and renal insufficiency were not increased (P > 0.05).ConclusionThe use of sacubitril-valsartan sodium in patients with acute myocardial infarction complicated with heart failure can significantly improve cardiac function and reverse ventricular remodeling, reducing the risk of re-hospitalization for heart failure. There is no apparent adverse reaction except easy cause hypotension.Systematic trial registration[www.ClinicalTrials.gov], identifier [CRD42022322901].

show abstract

Efficacy and safety of sacubitril valsartan in treating heart failure with midrange ejection fraction after acute myocardial infarction in diabetic patients

Cited by 4 publications

References 13 publications

Efficacy and safety of sacubitril/valsartan vs. valsartan in patients with acute myocardial infarction: A meta-analysis

Efficacy and safety of sacubitril/valsartan vs. valsartan in patients with acute myocardial infarction: A meta-analysis

Protective Effects of Ultrasound-Based Preoperative Exogenous Sacubitril/Valsartan on the Heart and Kidney of Patients Undergoing Percutaneous Coronary Intervention

A systematic review and meta-analysis of sacubitril-valsartan in the treatment of ventricular remodeling in patients with heart failure after acute myocardial infarction

Contact Info

Product

Resources

About