ABSTRACT
OBJECTIVE：To investigate the effec ts of angiotensin receptor neprilysin inhibitor （ARNI）sacubitril valsartan sodium（SVS）on the short-term prognosis of patients with acute anterior myocardial infarction （AAMI）complicated with acute cardiac insufficiency. METHODS ：A total of 80 patients with AAMI and Killip grade Ⅱ-Ⅳ of cardiac function ，who met the inclusion criteria ，were randomly divided into ARNI group and control group ，with 40 patients in each group. Both groups were given the same basic standardized drug treatment ，vital signs support treatment and percutaneous coronary intervention treatment at the same time. On this basis ，ARNI group was given SVS tablet orally ，with initial dose of 25 mg each time ，twice a day ； thereafter，gradually adjust the dose to 200 mg each time ，twice a day. Control group was given Enalapril maleate tablets orally ， with an initial dose of 5 mg each time ，twice a day ；thereafter，gradually adjust the dose to 10 mg each time ，twice a day. Both groups took medicine for a long time ，and were followed up after 1，3 and 6 months of medication to the clinic. The levels of N-terminal pro-B-type natriuretic peptide （NT-proBNP）， soluble growth stimulation expressed gene 2 protein （sST2） and echocardiography indexes were compared between 2 groups before and after medication. The 6-minute walking test （6MWT）and the incidence of cardiogenic readmission events were recorded in 2 groups after medication. RESULTS ：Compared with before treatment，the indexes of the two groups were significantly improved at 1，3 and 6 months after treatment （P＜0.05）. Compared with control group ，the levels of NT-proBNP and sST 2 in ARNI group decreased significantly （P＜0.05），the levels of left ventricular ejection fraction and 6MWT increased significantly（P＜0.05），and the left ventricular end systolic diameter and left ventricular end diastolic diameter decreased significantly，after 3 and 6 months of treatm ent（P＜0.05）. However ，there was no significant difference in the velocity ratio of peak E to peak A ，pulmonary artery pressure ，right ventricular end diastolic diameter and the incidence of cardiogenic readmission events between 2 groups（P＞0.05）. CONCLUSIONS ：For patients with AAMI complicated with acute cardiac insufficiency ， compared with enalapril ，SVS can significantly improve the cardiac function （especially the left ventricular systolic function ）， reduce the inflammatory reaction of cardiomyocytes ，protect cardiomyocytes ，so as to improve the short-term prognosis of patients.
ABSTRACT
Objective:To explore the influence of trimetazidine (TMZ)combined traditional routine drugs on progno-sis of patients with cardiac syndrome X.Methods:A total of 80 patients with cardiac syndrome X were randomly and equally divided into routine treatment group and TMZ group (received TMZ 20mg,three times/d based on routine medication).Both groups were treated for 12 weeks.Patients of two groups received treadmill exercise test and car-diac function examination before and after treatment,and the results were statistically compared.Results:Com-pared with routine treatment group after treatment,there were significant rise in total exercise time [(7.90±1.45) min vs.(9.35±1.70)min]and the time ST segment depressed 1mm [(5.30±1.43)min vs.(6.78±2.00)min], and significant reduction in ST segment depression extent [(0.89±0.30)mm vs.(0.61±0.20)mm],P <0.05 all;for cardiac function,there were significant rise in stroke volume [(67.99±11.77)ml vs.(74.05±7.58)ml]and left ventricular ejection fraction [(50.13±11.05)% vs.(56.02±9.52)%]in TMZ group,P <0.01 all.Conclusion:TMZ can significantly improve prognosis of patients with cardiac syndrome X.