Sacubitril-valsartan significantly reduced left ventricular end-diastolic dimension (WMD -3.11) and the risk of major adverse cardiac events (OR 0.36) compared to ACEI/ARB in patients with acute myocardial infarction after primary percutaneous coronary intervention.
Meta-Analysis (n=2,442)
Does sacubitril-valsartan improve left ventricular remodeling and reduce cardiovascular adverse events in AMI patients after PPCI compared to ACEI/ARB?
Sacubitril-valsartan may be superior to ACEI/ARB for improving left ventricular remodeling and reducing cardiovascular events in patients with acute myocardial infarction after primary PCI.
Effect estimate: WMD -3.11 (95% CI -4.05~-2.16)
p-value: p=<0.001
Background: Sacubitril-valsartan has been widely reported for reducing the risk of cardiovascular death and improving left ventricular remodeling in patients with heart failure (HF). However, the effect of sacubitril-valsartan in patients with acute myocardial infarction (AMI) remains controversial. Therefore, we conducted this meta-analysis to investigate whether sacubitril-valsartan could reverse left ventricular remodeling and reduce cardiovascular adverse events in AMI patients after primary percutaneous coronary intervention (PPCI). Materials and methods: Two researchers independently retrieved the relevant literature from PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure (CNKI), and the Wanfang database. The retrieval time was limited from inception to 1 June 2023. Randomized controlled trials (RCTs) meeting the inclusion criteria were included and analyzed. Results: < 0.001) were statistically significant. Conclusion: In conclusion, our meta-analysis indicates that compared with ACEI/ARB, sacubitril-valsartan may be superior to reverse left ventricular remodeling, improve cardiac function, and effectively reduce the risk of MACE, myocardial reinfarction, and HF in AMI patients after PPCI during follow-up without increasing the risk of adverse reactions including renal insufficiency, hyperkalemia, and symptomatic hypotension.
Liu et al. (Tue,) conducted a meta-analysis in Acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PPCI) (n=2,442). Sacubitril-valsartan vs. ACEI/ARB was evaluated on Left ventricular end-diastolic dimension (LVEDD) (WMD -3.11, 95% CI -4.05~-2.16, p=<0.001). Sacubitril-valsartan significantly reduced left ventricular end-diastolic dimension (WMD -3.11) and the risk of major adverse cardiac events (OR 0.36) compared to ACEI/ARB in patients with acute myocardial infarction after primary percutaneous coronary intervention.