Katihar Medical College, Katihar, Bihar.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
In patient with symptomatic heart failure sacubitril valsartan has been found to reduces the risk of hospitalization and death from cardiovascular causes more effectively then angiotensin converting enzymes inhibitor trail comparing the effect of these drugs in acute myocardial infarction is lacking.
We randomly assigned patient with acute myocardial infarction complicated with reduced LVEF, or pulmonary congestion to recieve sacubitril 97mg-valsartan 103mg and ramipril 5mg twice daily the primary outcome was death from cardiovascular causes or incident heart failure, outpatient symptomatic heart failure or heart failure leading to hospitalization whichever occure first.
Total 566 patient was taken in randomization 283 receive sacubitril-valsartan and 283 receive ramipril over a median of 22 months total outcome occure in 138 patient in sacubitril-valsartan group and in137 patient with ramipril group(hazard ratio 0.90: 95%confidence interval death from cardiovascular causes or hospitalization for heart failure occure i 10.9% patient reciveing sacubitril-valsartan and in 11.8%patient with ramipril group death from cardiovascular causes is 5.9 and 6.7% respectively death from anyother causes is 7.5 and 8.5 % respectively in both sacubitril-valsartan and ramipril group.
Sacubitril-valsartan was not associated with significantly lower incidence of death from cardiovascular causes or incidents heart failure then ramipril in patients with acute myocardial infarction.
在有症状心力衰竭的患者中，沙库巴曲缬沙坦已被发现比血管紧张素转换酶抑制剂试验更有效地降低心血管原因导致的住院和死亡风险，而比较这些药物在急性心肌梗死中的效果的研究则缺乏。
我们随机分配急性心肌梗死后 LVEF 降低或有肺充血的患者接受沙库巴曲缬沙坦 97mg-缬沙坦 103mg 和雷米普利 5mg 每日两次治疗，主要终点是心血管原因导致的死亡或新发心力衰竭、门诊有症状心力衰竭或导致住院的心衰，无论哪种情况先发生。
共有 566 例患者被随机分配，283 例接受沙库巴曲缬沙坦，283 例接受雷米普利，中位数随访 22 个月，沙库巴曲缬沙坦组共发生 138 例总结局，雷米普利组发生 137 例（风险比 0.90：95%置信区间，心血管原因导致的死亡或心力衰竭住院的发生率在接受沙库巴曲缬沙坦的患者中为 10.9%，在接受雷米普利的患者中为 11.8%，心血管原因导致的死亡分别为 5.9%和 6.7%，其他任何原因导致的死亡分别为 7.5%和 8.5%，在沙库巴曲缬沙坦和雷米普利组中均如此。
在急性心肌梗死后患者中，沙库巴曲缬沙坦与雷米普利相比，并不显著降低心血管原因导致的死亡或新发心力衰竭的发生率。
