Sacubitril/Valsartan Versus Valsartan in Elderly Patients With Acute Myocardial Infarction and Hypertension: Effects on Ventricular Remodeling and Short-term Prognosis After PCI: A Prospective Randomized Controlled Study
Abstract
Abstract Background In older adults, acute myocardial infarction (AMI) complicated by hypertension promotes adverse ventricular remodeling, impairs cardiac function, and increases the risk of unfavorable outcomes despite percutaneous coronary intervention (PCI). Although renin–angiotensin–aldosterone system inhibition is central to post-AMI management, residual cardiovascular risk remains. Whether early angiotensin receptor–neprilysin inhibition provides benefit in this high-risk population remains insufficiently defined. This study compared the efficacy and safety of sacubitril/valsartan with valsartan in elderly patients with AMI and hypertension after PCI. Methods This prospective, randomized, controlled trial enrolled 200 patients aged ≥ 65 years with AMI and hypertension who underwent PCI. Within 24 hours after PCI, participants were randomly assigned to receive sacubitril/valsartan or valsartan and were followed for 12 weeks. The primary outcome was the total effective rate, defined by improvement in left ventricular ejection fraction (LVEF) or New York Heart Association functional class. Secondary outcomes included LVEF, left ventricular end-diastolic diameter (LVEDD), inflammatory biomarkers, hypotension, and major adverse cardiovascular events (MACE). Between-group comparisons were performed using independent-samples t tests, Mann–Whitney U tests, chi-square tests, or Fisher’s exact tests, as appropriate. Repeated measures were evaluated using repeated-measures…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 200 participants or records.
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