Effect of Sacubitril/Valsartan Combined with Dapagliflozin on Cardiac Function and Prognosis after Emergency PCI in Patients with Acute ST-Segment Elevation Myocardial Infarction

Abstract

Abstract: Objective To investigate the effect of sacubitril/valsartan (ARNI) combined with dapagliflozin(SGLT2i) on cardiac function and prognosis after emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 140 eligible patients with STEMI who received emergency PCI were enrolled in the study and randomly assigned to receive treatment from January 2019 to December 2020. The patients presenting with left ventricular ejection fraction (LVEF)≥40% and NT-proBNP≥600 ng/L who were continuously enrolled. The patients were randomly divided into combination therapy group, ARNI group and ARB group. The data changes of NT proBNP, left ventricle ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD) and left ventricular fractional shortening (FS) before and after administration were taken as the primary endpoint. Follow up to June 2021, the occurrence of major adverse cardiovascular events (MACE) will be the secondary end point of this trial. Results There was no significant difference in clinical treatment data between the three groups. Compared with the ARB group, the decrease of NT-proBNP in the combination treatment group was more obvious, and the increase in LVEF and the reduction of LVEDD, LVESD were more obvious(P<0.05). A total of 23 patients developed MACE during follow-up, and there was no significant difference in the incidence of MACE between the three groups (P>0.05). Multivariate Cox regression analysis showed that the degree of lesion, intraoperative use of tirofiban and dopamine were independent risk factors for MACE (P<0.05). Conclusion Sacubitril/valsartan combined with dapagliflozin can more effectively reduce NT-proBNP levels, which may further increase the LVEF and reduce LVEDD, and improve the structure and function of the heart. Lesion complexity, intraoperative use of tirofiban, and dopamine are suggestive of a poor prognosis.

Key words: sacubitril/valsartan, dapagliflozin, acute myocardial infarction, percutaneous coronary intervention, prognosis

CLC Number:

G542.22

LYU Guo-ling, ZHANG Yi-ming, HUANG Jian-ying, XU Yao. Effect of Sacubitril/Valsartan Combined with Dapagliflozin on Cardiac Function and Prognosis after Emergency PCI in Patients with Acute ST-Segment Elevation Myocardial Infarction[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(13): 53-58.

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