Abstract：
BACKGROUND: infarction (AMI) can be reduced by the use of sacubitril/valsartan. However, the therapeutic effects of sacubitril/valsartan in clinical settings are inconsistent. In this paper, the related research on the application of sacubitril/valsartan in AMI was comprehensively searched, in order to explore the clinical efficacy and safety of early application of sacubitril/valsartan after AMI.
METHODS: English databases, including American National Library of Medicine, Medline, and Embase, and Chinese databases, including Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure (CNKI), Wanfang, and VIP, were searched using a combination of the following search terms: AMI, acute ST-segment elevation myocardial infarction (STEMI), acute non-ST-segment elevation myocardial infarction (NSTEMI), sacubitril/valsartan sodium tablets, and angiotensin receptor enkephalinase inhibitors. The experimental group was given Sacubitril/Valsartan sodium tablets, while the control group was given angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB). Cochrane Handbook 5.0 risk assessment table were used for quality assessment and bias risk assessment.
RESULTS: A total of 5 articles were included in the meta-analysis. The total incidence of adverse cardiovascular events in the sacubitril/valsartan group was significantly lower than that in the control group {relative risk (RR) =0.61 [95% confidence interval (CI): 0.46, 0.82], significance testing Z=3.36, and P=0.0008}. The difference between the rehospitalization rate of the sacubitril/valsartan group and control group was statistically significant [RR =0.67 (95% CI: 0.47, 0.95), significance testing Z=2.23, and P=0.03]. The difference in low blood pressure between the sacubitril/valsartan group and the control group was statistically significant [RR =1.28 (95% CI: 1.18, 1.40), significance testing Z=5.58, and P<0.00001]. The difference in left ventricular ejection fraction (LVEF) between the sacubitril/valsartan group and control group was statistically significant [mean difference (MD) =3.09 (95% CI: 1.69, 4.49), significance testing Z=4.33, and P<0.0001].
CONCLUSIONS: Sacubitril/valsartan was found to inhibit ventricular remodeling after AMI, improve cardiac function, and reduce the incidence of adverse cardiovascular events after myocardial infarction, the rehospitalization rate, and the mortality rate.
METHODS: English databases, including American National Library of Medicine, Medline, and Embase, and Chinese databases, including Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure (CNKI), Wanfang, and VIP, were searched using a combination of the following search terms: AMI, acute ST-segment elevation myocardial infarction (STEMI), acute non-ST-segment elevation myocardial infarction (NSTEMI), sacubitril/valsartan sodium tablets, and angiotensin receptor enkephalinase inhibitors. The experimental group was given Sacubitril/Valsartan sodium tablets, while the control group was given angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB). Cochrane Handbook 5.0 risk assessment table were used for quality assessment and bias risk assessment.
RESULTS: A total of 5 articles were included in the meta-analysis. The total incidence of adverse cardiovascular events in the sacubitril/valsartan group was significantly lower than that in the control group {relative risk (RR) =0.61 [95% confidence interval (CI): 0.46, 0.82], significance testing Z=3.36, and P=0.0008}. The difference between the rehospitalization rate of the sacubitril/valsartan group and control group was statistically significant [RR =0.67 (95% CI: 0.47, 0.95), significance testing Z=2.23, and P=0.03]. The difference in low blood pressure between the sacubitril/valsartan group and the control group was statistically significant [RR =1.28 (95% CI: 1.18, 1.40), significance testing Z=5.58, and P<0.00001]. The difference in left ventricular ejection fraction (LVEF) between the sacubitril/valsartan group and control group was statistically significant [mean difference (MD) =3.09 (95% CI: 1.69, 4.49), significance testing Z=4.33, and P<0.0001].
CONCLUSIONS: Sacubitril/valsartan was found to inhibit ventricular remodeling after AMI, improve cardiac function, and reduce the incidence of adverse cardiovascular events after myocardial infarction, the rehospitalization rate, and the mortality rate.
摘要：
背景：可以通过使用沙库巴曲/缬沙坦来减少梗塞（AMI）。然而,沙库必曲/缬沙坦在临床治疗中的疗效不一致.在本文中,全面搜索了沙库巴曲/缬沙坦在AMI中应用的相关研究，探讨AMI后早期应用沙库巴曲/缬沙坦的临床疗效及安全性。
方法：英文数据库，包括美国国家医学图书馆,Medline,和Embase,和中国数据库，包括中国生物医学文献数据库，中国国家知识基础设施(CNKI),万方,VIP,使用以下搜索词的组合进行搜索：AMI，急性ST段抬高型心肌梗死(STEMI),急性非ST段抬高型心肌梗死(NSTEMI),沙库巴曲/缬沙坦钠片，和血管紧张素受体脑啡肽酶抑制剂。实验组给予沙巴曲/缬沙坦钠片,对照组给予血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂(ACEI/ARB)。采用CochraneHandbook5.0风险评估表进行质量评估和偏倚风险评估。
结果：共有5篇文献纳入荟萃分析。沙库巴曲/缬沙坦组心血管不良事件总发生率明显低于对照组{相对危险度(RR)=0.61[95%可信区间(CI):0.46,0.82],显著性检验Z=3.36，P=0.0008}。沙库巴曲/缬沙坦组与对照组的再住院率差异有统计学意义[RR=0.67(95%CI:0.47,0.95),显著性检验Z=2.23，P=0.03]。沙库必曲/缬沙坦组与对照组之间的低血压差异有统计学意义[RR=1.28（95％CI：1.18，1.40），显著性检验Z=5.58，P<0.00001]。沙库必曲/缬沙坦组与对照组的左心室射血分数（LVEF）差异有统计学意义[平均差异（MD）=3.09（95％CI：1.69，4.49），显著性检验Z=4.33，P<0.0001]。
结论：发现舒必曲/缬沙坦抑制AMI后心室重构，改善心脏功能，降低心肌梗死后不良心血管事件的发生率,再住院率，和死亡率。
方法：英文数据库，包括美国国家医学图书馆,Medline,和Embase,和中国数据库，包括中国生物医学文献数据库，中国国家知识基础设施(CNKI),万方,VIP,使用以下搜索词的组合进行搜索：AMI，急性ST段抬高型心肌梗死(STEMI),急性非ST段抬高型心肌梗死(NSTEMI),沙库巴曲/缬沙坦钠片，和血管紧张素受体脑啡肽酶抑制剂。实验组给予沙巴曲/缬沙坦钠片,对照组给予血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂(ACEI/ARB)。采用CochraneHandbook5.0风险评估表进行质量评估和偏倚风险评估。
结果：共有5篇文献纳入荟萃分析。沙库巴曲/缬沙坦组心血管不良事件总发生率明显低于对照组{相对危险度(RR)=0.61[95%可信区间(CI):0.46,0.82],显著性检验Z=3.36，P=0.0008}。沙库巴曲/缬沙坦组与对照组的再住院率差异有统计学意义[RR=0.67(95%CI:0.47,0.95),显著性检验Z=2.23，P=0.03]。沙库必曲/缬沙坦组与对照组之间的低血压差异有统计学意义[RR=1.28（95％CI：1.18，1.40），显著性检验Z=5.58，P<0.00001]。沙库必曲/缬沙坦组与对照组的左心室射血分数（LVEF）差异有统计学意义[平均差异（MD）=3.09（95％CI：1.69，4.49），显著性检验Z=4.33，P<0.0001]。
结论：发现舒必曲/缬沙坦抑制AMI后心室重构，改善心脏功能，降低心肌梗死后不良心血管事件的发生率,再住院率，和死亡率。
