Liu Shanshan, Yin Bi, Wu Bo, Fan Zhixing
Department of Physical Examination, 904th Hospital of Joint Logistic Support Force of PLA, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu 214000, P.R. China.
Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443000, P.R. China.
Exp Ther Med. 2022 Jun;23(6):406. doi: 10.3892/etm.2022.11333. Epub 2022 Apr 21.
To evaluate the effects and safety of sacubitril/valsartan in patients with acute myocardial infarction (AMI), a total of four databases, including PubMed, Cochrane Library, Embase and Web of Science, and the ClinicalTrials.gov website were searched. Using a combination of medical subject headings and entry terms, the final search was performed in July 2021. A manual search of cross-references from the original articles was also conducted. The meta-analysis was subsequently performed with Revman 5.3 software and a total of four studies comprising 586 patients were included. The results disclosed a significant reduction in major adverse cardiovascular and cerebrovascular events (MACCEs) [odds ratio (OR), 0.47; 95% confidence interval (CI), 0.30-0.73; P=0.0007], readmission (OR, 0.45; 95% CI, 0.29-0.71; P=0.0006), incidence of acute heart failure (AHF) (OR, 0.45; 95% CI, 0.28-0.71; P=0.0007) and N-terminal pro B-type natriuretic peptide [standardized mean difference (SMD), -0.88; 95% CI, -1.55-(-0.21); P=0.01] in the sacubitril/valsartan group compared with that in the control group, and a random effects model was used to pool these data. No significant differences were identified in the incidence of hypotension (OR, 2.91; 95% CI, 0.55-15.51; P=0.21), adverse events (OR, 2.19; 95% CI, 0.42-11.37; P=0.35), left ventricular ejection fraction (mean difference, 1.96; 95% CI, -0.84-4.76; P=0.17) or soluble suppression of tumorigenesis-2 (SMD, -0.45; 95% CI, -1.62-0.71; P=0.45) according to the random effects model. In conclusion, the present meta-analysis revealed that sacubitril/valsartan was able to effectively reduce the incidence of MACCEs, readmission and AHF in patients with AMI after revascularization without any obvious adverse events.
为评估沙库巴曲缬沙坦对急性心肌梗死（AMI）患者的疗效及安全性，检索了包括PubMed、Cochrane图书馆、Embase和Web of Science在内的4个数据库以及ClinicalTrials.gov网站。采用医学主题词和检索词相结合的方式，于2021年7月进行了最终检索。还对手动检索原始文章的参考文献进行了检索。随后使用Revman 5.3软件进行荟萃分析，共纳入4项研究，涉及586例患者。结果显示，与对照组相比，沙库巴曲缬沙坦组的主要不良心血管和脑血管事件（MACCEs）显著减少[比值比（OR），0.47；95%置信区间（CI），0.30 - 0.73；P = 0.0007]、再入院率（OR，0.45；95% CI，0.29 - 0.71；P = 0.0006）、急性心力衰竭（AHF）发生率（OR，0.45；95% CI，0.28 - 0.71；P = 0.0007）和N末端B型利钠肽原[标准化均数差（SMD），-0.88；95% CI，-1.55 -（-0.21）；P = 0.01]，并采用随机效应模型汇总这些数据。根据随机效应模型，低血压发生率（OR，2.91；95% CI，0.55 - 15.51；P = 0.21）、不良事件发生率（OR，2.19；95% CI，0.42 - 11.37；P = 0.35）、左心室射血分数（均数差，1.96；95% CI，-0.84 - 4.76；P = 0.17）或可溶性肿瘤发生抑制因子-2（SMD，-0.45；95% CI，-1.62 - 0.71；P = 0.45）未发现显著差异。总之，本荟萃分析表明，沙库巴曲缬沙坦能够有效降低AMI患者血管重建术后MACCEs、再入院率和AHF的发生率，且无明显不良事件。
