A Retrospective Study of Whether Sacubitril–Valsartan Improves Cardiac Function in Patients with Acute Coronary Syndrome and Hypertension after Percutaneous Coronary Intervention

Authors

  • Fuzhong Liu Department of Cardiovasclar Medicine, The First People's Hospital of Jiashan, 314100 Jiaxing, Zhejiang, China
  • Jia Lu Department of Cardiovasclar Medicine, The First People's Hospital of Jiashan, 314100 Jiaxing, Zhejiang, China
  • Yongchao Dong Department of Cardiovasclar Medicine, The First People's Hospital of Jiashan, 314100 Jiaxing, Zhejiang, China
  • Yingjun Yang Department of Cardiovasclar Medicine, The First People's Hospital of Jiashan, 314100 Jiaxing, Zhejiang, China

DOI:

https://doi.org/10.59958/hsf.7351

Keywords:

sacubitril–valsartan, acute coronary syndrome, hypertension, percutaneous coronary intervention, cardiac function

Abstract

Objectives: This study aimed to explore the effect of sacubitril–valsartan on cardiac function in patients with acute coronary syndrome (ACS) and hypertension after percutaneous coronary intervention (PCI). Methods: The study was conducted on 166 patients with ACS and hypertension who underwent PCI at our hospital from July 2022 to June 2023. The patients were divided into two groups: an observation group and a control group, with 83 cases in each group. The observation group was given sacubitril–valsartan, and the control group was given enalapril. The treatment period was 3 months. The cardiac function indexes, biochemical indexes, adverse reactions, and the occurrence of new cardiovascular and cerebrovascular events were compared between the two groups before and after medication. Results: We found no statistically dramatic differences between the two groups in gender, age, body mass index, diabetes, hyperlipidemia, family history of ACS, family history of hypertension, smoking history, drinking history, regular exercise history, low-salt and low-fat diet, New York Heart Association cardiac function classification, number of vessels involved in coronary artery disease, stent length, stent inner diameter, number of stent implants, duration of hypertension, medication time, use of antihypertensive drugs, systolic blood pressure (SBP), and diastolic blood pressure (DBP). The observation group had lower left ventricular end-diastolic internal diameter (LVEDD) levels, higher left ventricular ejection fraction (LVEF) levels, and lower left ventricular end-systolic internal diameter (LVESD) levels compared with the control group. The levels of N-terminal pro-brain B-type natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), and creatine kinase isoenzyme MB (CK-MB) in the observation group decreased compared with those in the control group. Compared with the pre-medication period, LVEDD levels decreased, LVEF levels increased, and LVESD levels decreased in the observation and control groups, whereas NT-proBNP, cTnI, and CK-MB levels decreased in the observation and control groups. The total incidence rates of adverse reactions and new cardiovascular and cerebrovascular events in the observation group were found to be lower than those in the control group. Conclusion: The application of sacubitril–valsartan in patients with ACS complicated with hypertension after PCI can effectively improve patients' cardiac function, reduce biochemical indexes related to myocardial injury, and lower the incidence of adverse cardiovascular events. It features good safety, providing a new treatment strategy and method for patients with ACS complicated with hypertension.

References

Damluji AA, Forman DE, Wang TY, Chikwe J, Kunadian V, Rich MW, et al. Management of Acute Coronary Syndrome in the Older Adult Population: A Scientific Statement From the American Heart Association. Circulation. 2023; 147: e32–e62.

Harrington J, Jones WS, Udell JA, Hannan K, Bhatt DL, Anker SD, et al. Acute Decompensated Heart Failure in the Setting of Acute Coronary Syndrome. JACC. Heart Failure. 2022; 10: 404–414.

Bergmark BA, Mathenge N, Merlini PA, Lawrence-Wright MB, Giugliano RP. Acute coronary syndromes. Lancet. 2022; 399: 1347–1358.

Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. European Heart Journal. 2023; 44: 3720–3826.

Diletti R, den Dekker WK, Bennett J, Schotborgh CE, van der Schaaf R, Sabaté M, et al. Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial. Lancet. 2023; 401: 1172–1182.

Bhatt DL, Lopes RD, Harrington RA. Diagnosis and Treatment of Acute Coronary Syndromes: A Review. JAMA. 2022; 327: 662–675.

Capodanno D, Angiolillo DJ. Timing, Selection, Modulation, and Duration of P2Y12 Inhibitors for Patients With Acute Coronary Syndromes Undergoing PCI. JACC. Cardiovascular Interventions. 2023; 16: 1–18.

Xia Y, Wang Z, Gao F, Yang L, Liang J, Shi D, et al. Effect of Presence versus Absence of Hypertension on Admission Heart Rate-Associated Cardiovascular Risk in Patients with Acute Coronary Syndrome. International Journal of Hypertension. 2022; 2022: 3001737.

Zhang S, Liu X, Song B, Yu H, Zhang X, Shao Y. Impact of serum uric acid levels on the clinical prognosis and severity of coronary artery disease in patients with acute coronary syndrome and hypertension after percutaneous coronary intervention: a prospective cohort study. BMJ Open. 2022; 12: e052031.

Ledwidge M, Dodd JD, Ryan F, Sweeney C, McDonald K, Fox R, et al. Effect of Sacubitril/Valsartan vs Valsartan on Left Atrial Volume in Patients With Pre-Heart Failure With Preserved Ejection Fraction: The PARABLE Randomized Clinical Trial. JAMA Cardiology. 2023; 8: 366–375.

Felker GM, Butler J, Ibrahim NE, Piña IL, Maisel A, Bapat D, et al. Implantable Cardioverter-Defibrillator Eligibility After Initiation of Sacubitril/Valsartan in Chronic Heart Failure: Insights From PROVE-HF. Circulation. 2021; 144: 180–182.

Liu H, Su Y, Shen J, Jiao Y, Li Y, Liu B, et al. Improved heart function and cardiac remodelling following sacubitril/valsartan in acute coronary syndrome with HF. ESC Heart Failure. 2024; 11: 937–949.

Sultana S, K MS, Prakash VR, Karthikeyan A, Aslam S SM, C SG, et al. Evaluation of Uric Acid to Albumin Ratio as a Marker of Coronary Artery Disease Severity in Acute Coronary Syndrome: A Cross-Sectional Study. Cureus. 2023; 15: e49454.

Lawless M, Damluji A, Dirjayanto VJ, Mills G, Pompei G, Rubino F, et al. Differences in treatment and clinical outcomes in patients aged ≥75 years compared with those aged ≤74 years following acute coronary syndromes: a prospective multicentre study. Open Heart. 2023; 10: e002418.

Zhang D, Li P, Qiu M, Liang Z, He J, Li Y, et al. Net clinical benefit of clopidogrel versus ticagrelor in elderly patients carrying CYP2C19 loss-of-function variants with acute coronary syndrome after percutaneous coronary intervention. Atherosclerosis. 2024; 390: 117395.

Wang J, Zhao J, Lin Q, Xu X, Jiang K, Li Y. ΔRDW Could Predict Major Adverse Cardiovascular Events in Patients with Heart Failure with Reduced Ejection Fraction After Sacubitril/Valsartan Treatment. International Journal of General Medicine. 2023; 16: 5989–6003.

Hou C, Hao X, Sun N, Luo X, Gao Z, Chen L, et al. Predicting Hospital Readmissions in Patients Receiving Novel-Dose Sacubitril/Valsartan Therapy: A Competing-Risk, Causal Mediation Analysis. Journal of Cardiovascular Pharmacology and Therapeutics. 2023; 28: 10742484231219603.

Bhattacharjee P, Khan Z. Sacubitril/Valsartan in the Treatment of Heart Failure With Reduced Ejection Fraction Focusing on the Impact on the Quality of Life: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Cureus. 2023; 15: e48674.

Shi L, Ye Z, Gu Q, Li Y. Effect of statins combined with PCSK9 inhibitors on the prognosis of patients with acute coronary syndromes after interventional therapy. Cellular and Molecular Biology. 2023; 69: 262–267.

Hemmati R, Mohsenzadeh Y, Madadi R. Association between the increased level of high-sensitive CRP (hs CRP) and non-arrhythmic ECG changes and echocardiographic abnormalities in patients with acute coronary syndrome. Caspian Journal of Internal Medicine. 2023; 14: 83–88.

Volpe M, Bauersachs J, Bayés-Genís A, Butler J, Cohen-Solal A, Gallo G, et al. Sacubitril/valsartan for the management of heart failure: A perspective viewpoint on current evidence. International Journal of Cardiology. 2021; 327: 138–145.

Januzzi JL, Jr, Prescott MF, Butler J, Felker GM, Maisel AS, McCague K, et al. Association of Change in N-Terminal Pro-B-Type Natriuretic Peptide Following Initiation of Sacubitril-Valsartan Treatment With Cardiac Structure and Function in Patients With Heart Failure With Reduced Ejection Fraction. JAMA. 2019; 322: 1085–1095.

Desai AS, Solomon SD, Shah AM, Claggett BL, Fang JC, Izzo J, et al. Effect of Sacubitril-Valsartan vs Enalapril on Aortic Stiffness in Patients With Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial. JAMA. 2019; 322: 1077–1084.

Gallo G, Tocci G, Fogacci F, Battistoni A, Rubattu S, Volpe M. Blockade of the neurohormonal systems in heart failure with preserved ejection fraction: A contemporary meta-analysis. International Journal of Cardiology. 2020; 316: 172–179.

Chen GX, Wang HN, Zou JL, Yuan XX. Effects of intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction after emergency PCI. World Journal of Emergency Medicine. 2020; 11: 157–163.

Kumar S, Griffith N, Walter D, Swett M, Raman V, Vargas JD, et al. Characterization of Myocardial Injury With High-Sensitivity Troponin. Texas Heart Institute Journal. 2023; 50: e238108.

Katsioupa M, Kourampi I, Oikonomou E, Tsigkou V, Theofilis P, Charalambous G, et al. Novel Biomarkers and Their Role in the Diagnosis and Prognosis of Acute Coronary Syndrome. Life. 2023; 13: 1992.

Kido K, Colvin BM, Szymanski TW, Guglin M. Sacubitril/Valsartan Off-Label Uses for Heart Failure. Journal of Cardiac Failure. 2022; 28: 1185–1201.

Karaayvaz EB, Güz G. Coronary Flow Reserve Changes after Angiotensin Receptor-Neprilysin Inhibitor Treatment in Heart Failure with Reduced Ejection Fraction. Acta Cardiologica Sinica. 2023; 39: 871–878.

Docherty KF, Vaduganathan M, Solomon SD, McMurray JJV. Sacubitril/Valsartan: Neprilysin Inhibition 5 Years After PARADIGM-HF. JACC. Heart Failure. 2020; 8: 800–810.

Published

2024-06-17

How to Cite

Liu, F., Lu, J., Dong, Y., & Yang, Y. (2024). A Retrospective Study of Whether Sacubitril–Valsartan Improves Cardiac Function in Patients with Acute Coronary Syndrome and Hypertension after Percutaneous Coronary Intervention. The Heart Surgery Forum, 27(6), E619-E627. https://doi.org/10.59958/hsf.7351

Issue

Section

Article