In STEMI patients with mid-range LVEF, initial treatment with sacubitril/valsartan significantly improved left ventricular ejection fraction at 1 month compared to benazepril (52.89% vs 47.85%, p=0.006).
Observational (n=134)
Observer-blind
No
Does sacubitril/valsartan improve short-term cardiac systolic function and clinical outcomes compared to benazepril in STEMI patients with mid-range LVEF?
In STEMI patients with mid-range LVEF, initial treatment with sacubitril/valsartan improved short-term echocardiographic parameters of systolic function more than benazepril, with a comparable safety profile.
Tasa de eventos absoluta: 52.89% vs 47.85%
valor p: p=0.006
Objective We assessed the safety and efficacy of initial treatment with sacubitril/valsartan (S/V) in STEMI patients with mid-range left ventricular ejection fraction (LVEF, 40%–49%). Methods We consecutively enrolled STEMI patients who received successful reperfusion therapy at the Second Hospital of Hebei Medical University between January 2019 and January 2025. Clinic follow-up visits were performed at 2 weeks and 1 month after treatment initiation. PSM was used to balance baseline characteristics between the benazepril and S/V cohorts, minimizing selection bias and confounding. Echocardiographic parameters were assessed at baseline (within 24 h of symptom onset) and at the 1-month follow-up. Major adverse cardiac events (MACE) and safety outcomes were systematically reported. Results A total of 134 eligible patients were enrolled, including 96 in the S/V cohort and 38 in the benazepril cohort. After 1:1 PSM, 35 patients were included in each matched group, with well-balanced baseline characteristics. After 1 month of treatment, the S/V group showed a significantly greater reduction in left ventricular end-systolic volume (LVESV), as well as greater improvements in left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (GLS), compared with the benazepril group (all P 0.05). There were no significant between-group differences in the incidence of major adverse cardiac events (MACE) or safety endpoints (all P 0.05). Conclusion In STEMI patients with mid-range LVEF, initial S/V and benazepril treatment had comparable safety profiles. S/V showed superior efficacy in improving short-term cardiac systolic function, as measured by surrogate echocardiographic endpoints. These preliminary findings require validation in larger, prospective randomized controlled trials with longer follow-up to confirm whether these benefits translate into improved long-term clinical outcomes.
Wang et al. (Thu,) conducted a observational in ST-segment elevation myocardial infarction (STEMI) with mid-range ejection fraction (n=134). Sacubitril/valsartan vs. Benazepril was evaluated on Left ventricular ejection fraction (LVEF) at 1 month (p=0.006). In STEMI patients with mid-range LVEF, initial treatment with sacubitril/valsartan significantly improved left ventricular ejection fraction at 1 month compared to benazepril (52.89% vs 47.85%, p=0.006).