Clinical efficacy and safety of angiotensin receptor neprilysin inhibitor and angiotensin converting enzyme inhibitor in elderly patients with ischemic cardiomyopathy / 中国医师进修杂志

ABSTRACT

Objective To investigate the influence of angiotensinreceptor neprilysin inhibitor (ARNI) and angiotensin converting enzyme inhibitor (ACEI) on clinical efficacy and safety of elderly patients with ischemic cardiomyopathy.Methods From January 2017 to December 2018,120 elderly patients with ischemic cardiomyopathy in the Third People's Hospital of Cixi were divided into 2 groups according to treatment methods,59 patients treated with ACEI (control group) and 61 patients treated with ARNI (observation group) on the basis of conventional intervention.The levels of blood lipid index,blood pressure index,B-type brain natriuretic peptide (BNP),6-minute walking test (6MWT) and echocardiographic index,endothelium-dependent diastolic function of brachial artery (FMD) and carotid intima-media thickness (CIMT) before and after treatment were compared.The adverse reactions incidence of 2 groups were compared.Results The levels of blood lipid index and blood pressure index after treatment of 2 groups were significantly lower than those before treatment,and the differences had statistical significant (P ＜ 0.05).There were no significant differences in the levels of blood lipid index and blood pressure index after treatment between 2 groups (P ＞ 0.05).After treatment of 12 weeks,the levels of BNP,6MWT,left ventricular ejection fraction (LVEF),left ventricular end-diastolic dimension (LVEDD) of observation group were significantly better than those of control group [(103.50 ± 23.95) ng/L vs.(175.20 ± 37.24) ng/L,(493.47 ± 92.54) m vs.(411.42 ± 61.09) m,(44.95 ± 5.89)％ vs.(41.54 ± 4.21)％,(149.59 ± 33.26) mm vs.(143.24 ± 34.25) mm](P ＜ 0.05).The level of brachial artery FMD after treatment of observation group was significantly higher than that of control group [(15.14 ± 2.52)％ vs.(9.25 ± 1.12)％](P ＜ 0.05).The level of CIMT after treatment of observation group was significantly lower than that of control group [(1.01 ± 0.28) mm vs.(1.32 ± 0.25) mm] (P＜ 0.05).There was no significant difference in the adverse reactions incidence between 2 groups (P＞ 0.05).Conclusions ARNI in assisted treatment of elderly patients with ischemic cardiomyopathy can efficiently improve cardiac function,increase exercise endurance,enhance vasodilation function and dose not aggravate adverse drug reactions.