Enhancing ventricular remodeling and cardiac function in post-acute myocardial infarction with sacubitril/valsartan

OBJECTIVE: To evaluate the therapeutic effect of sacubitril/valsartan compared to enalapril in managing heart failure (HF) after percutaneous coronary intervention (PCI). METHODS: From January 2018 to December 2021, 63 hospitalized patients diagnosed with HF following acute myocardial infarction (AMI) were enrolled in this prospective clinical trial. The observation group was comprised of 31 patients treated with sacubitril/valsartan (LCZ696) sodium tablets, while the control group, including 32 patients, received enalapril maleate tablets. All patients received standard HF therapy, including water-soluble aspirin, hydroclopidogrel sulfate, once-daily bivalirudin calcium, twice-daily metoprolol tartrate (dose titrated based on heart rate), once-daily spironolactone (dose adjusted for electrolytes), and once-daily dehydroimidazole (dose adjusted for electrolytes). HF symptom control, N-terminal B-type natriuretic peptide precursor (NT-proBNP) levels, cardiac anatomical parameters, heart rate, blood pressure, and 6-minute walking distance over a 90-day follow-up were assessed. The study is registered under ClinicalTrials.gov [ChiCTR2100042944]. RESULTS: On the 30th day post-discharge, the observation group exhibited a marked decrease in NT-proBNP levels and an improvement in left ventricular end-diastolic diameter, in contrast to the control group (both P<0.05). By the 90th day, the observation group showed significant improvements in left ventricular ejection fraction and left ventricular end-systolic diameter index, along with reduced blood pressure and serum creatinine levels (all P<0.05). Furthermore, the observation group displayed a more favorable New York Heart Association class distribution and enhanced performance in the 6-minute walk test (both P<0.05). No significant difference in the incidence of major adverse cardiovascular events was observed between the two groups during the 90-day follow-up period (P>0.05). CONCLUSION: Our findings indicate that sacubitril/valsartan (LCZ696) Sodium Tablets effectively enhance ventricular remodeling and cardiac function in patients with HF post-AMI, following a short-term treatment regimen. This therapeutic approach holds promise for improving clinical outcomes in this patient population.