The benefits of sacubitril-valsartan in patients with acute myocardial infarction: a systematic review and meta-analysis.
The benefits of sacubitril-valsartan in patients with acute myocardial infarction: a systematic review and meta-analysis.
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沙库巴曲缬沙坦对急性心肌梗死患者的益处：系统评价和荟萃分析
DOI：
10.1002/ehf2.13677
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发表时间：
2021-12
影响因子：
3.8
通讯作者：
Huang J
中科院分区：
文献类型：
--
作者：
Xiong B;Nie D;Qian J;Yao Y;Yang G;Rong S;Zhu Q;Du Y;Jiang Y;Huang J
我们的目的是研究沙库比曲-缬沙坦是否可以进一步改善急性心肌梗死（AMI）患者的预后、心功能和左心室（LV）重构。我们检索了PubMed、Embase、科克伦图书馆和中国知网（CNKI），从开始到2021年5月10日，以识别潜在文章。纳入符合纳入标准的随机对照试验（RCT）并进行分析。共分析了13项RCT，涵盖1358例患者。与血管紧张素转换酶抑制剂（ACEI）/血管紧张素受体阻滞剂（ARB）相比，沙库巴曲-缬沙坦未显著降低心血管死亡率[风险比（RR）0.65，95%置信区间（CI）0.22 - 1.93，P = 0.434]和心肌再梗死率（RR 0.65，95%CI 0.29 ~ 1.46，P = 0.295），但因心力衰竭（HF）住院的发生率（RR 0.48，95% CI 0.35 ~ 0.66，P < 0.001）和左室射血分数（LVEF）变化[加权平均差（WMD）5.49，95% CI 3.62 ~ 7.36，P < 0.001]明显改善。沙库巴曲-缬沙坦组的N末端脑钠肽前体（NT-ProBNP）水平（WMD − 310. 23，95% CI − 385. 89至− 234. 57，P <0. 001）和左室舒张末期内径（LVEDD）（WMD − 3. 16，95% CI − 4. 59至− 1. 73，P <0. 001）也显著低于ACEI/ARB组。关于安全性，沙库比曲-缬沙坦不会增加低血压、高钾血症、血管性水肿和咳嗽的风险。这项Meta分析表明，在AMI后患者中，沙库比曲-缬沙坦早期给药可能上级传统ACEI/ARB，可降低因HF住院的风险，改善心功能，逆转LV重构。
We aimed to investigate whether sacubitril–valsartan could further improve the prognosis, cardiac function, and left ventricular (LV) remodelling in patients following acute myocardial infarction (AMI). We searched the PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI) from inception to 10 May 2021 to identify potential articles. Randomized controlled trials (RCTs) meeting the inclusion criteria were included and analysed. Thirteen RCTs, covering 1358 patients, were analysed. Compared with angiotensin‐converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB), sacubitril–valsartan did not significantly reduced the cardiovascular mortality [risk ratio (RR) 0.65, 95% confidence interval (CI) 0.22 to 1.93, P = 0.434] and the rate of myocardial reinfarction (RR 0.65, 95% CI 0.29 to 1.46, P = 0.295) of patients following AMI, but the rate of hospitalization for heart failure (HF) (RR 0.48, 95% CI 0.35 to 0.66, P < 0.001) and the change of LV ejection fraction (LVEF) [weighted mean difference (WMD) 5.49, 95% CI 3.62 to 7.36, P < 0.001] were obviously improved. The N‐terminal pro‐brain natriuretic peptide (NT‐ProBNP) level (WMD −310.23, 95% CI −385.89 to −234.57, P < 0.001) and the LV end‐diastolic dimension (LVEDD) (WMD −3.16, 95% CI −4.59 to −1.73, P < 0.001) were also significantly lower in sacubitril–valsartan group than in ACEI/ARB group. Regarding safety, sacubitril–valsartan did not increase the risk of hypotension, hyperkalaemia, angioedema, and cough. This meta‐analysis suggests that early administration of sacubitril–valsartan may be superior to conventional ACEI/ARB to decrease the risk of hospitalization for HF, improve the cardiac function, and reverse the LV remodelling in patients following AMI.
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影响因子：
158.5
作者：
Solomon, S. D.;McMurray, J. J. V.;Lefkowitz, M. P.
通讯作者：
Lefkowitz, M. P.
影响因子：
3.7
作者：
Moher D;Shamseer L;Clarke M;Ghersi D;Liberati A;Petticrew M;Shekelle P;Stewart LA;PRISMA-P Group
通讯作者：
PRISMA-P Group
DOI：
10.1136/heartjnl-2014-306775
发表时间：
2016-09-01
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Jhund PS;McMurray JJ
通讯作者：
McMurray JJ
影响因子：
4.8
作者：
Kaul, Padma;Ezekowitz, Justin A.;McAlister, Finlay A.
通讯作者：
McAlister, Finlay A.
影响因子：
37.8
作者：
Docherty KF;Campbell RT;Brooksbank KJM;Dreisbach JG;Forsyth P;Godeseth RL;Hopkins T;Jackson AM;Lee MMY;McConnachie A;Roditi G;Squire IB;Stanley B;Welsh P;Jhund PS;Petrie MC;McMurray JJV
通讯作者：
McMurray JJV