Early ARNI therapy significantly reduced the risk of major adverse cardiac events compared to ACEI/ARB in patients with acute anterior myocardial infarction (HR 0.392; 95% CI 0.194-0.791; P=0.009).
Cohort (n=168)
Does early sacubitril/valsartan therapy improve ventricular remodeling and reduce major adverse cardiac events compared to ACEI/ARB in patients with acute anterior myocardial infarction?
Early initiation of sacubitril/valsartan in patients with acute anterior myocardial infarction improves left ventricular remodeling and reduces the risk of major adverse cardiac events compared to ACEI/ARB therapy.
Hazard Ratio: 0.392 (95% CI 0.194–0.791)
p-value: p=0.009
PURPOSE: To compare the effects of early angiotensin receptor-neprilysin inhibitor (ARNI) versus angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) therapy on left ventricular remodeling and heart failure progression in patients with acute anterior wall myocardial infarction. METHODS: Patients were stratified by treatment into ARNI (n = 97) and ACEI/ARB (n = 71) groups. Baseline characteristics, cardiac ultrasound data (baseline, 0-3 months, 6-12 months), and major adverse cardiac events (MACEs) were analyzed. RESULTS: The ARNI group demonstrated significantly greater improvements in left ventricular end-diastolic diameter and relative wall thickness versus the ACEI/ARB group. Subgroup analyses (target-dose achievers, emergency reperfusion recipients, left ventricular ejection fraction ≥50 % patients) consistently showed better improvements with ARNI. ARNI therapy also significantly reduced MACEs risk (HR = 0.392, 95 % CI: 0.194-0.791, P = 0.009). CONCLUSION: Compared with ACEI/ARB, ARNI demonstrated enhanced preservation of cardiac function, attenuation of adverse ventricular remodeling, and maintenance of ventricular geometry following myocardial infarction. Additionally, ARNI was associated with a reduction in major adverse cardiac events and improved survival outcomes.
Ye et al. (2025) conducted a cohort in acute anterior wall myocardial infarction (n=168). Early angiotensin receptor-neprilysin inhibitor (ARNI) vs. angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) was evaluated on major adverse cardiac events (MACEs) (HR 0.392, 95% CI 0.194-0.791, p=0.009). Early ARNI therapy significantly reduced the risk of major adverse cardiac events compared to ACEI/ARB in patients with acute anterior myocardial infarction (HR 0.392; 95% CI 0.194-0.791; P=0.009).