Abstract：Objective To compare the clinical effect of Sacubitril-Valsartan and Irbesartan in the treatment of chronic heart failure. Methods From June 2018 to December 2020, 100 patients with coronary heart disease complicated with chronic heart failure who were admitted to the Second Department of Circulatory Medicine, Changchun People′s Hospital were selected as the research subjects. They were divided into an observation group (50 cases) and a control group (50 cases) according to random number table method. Among them, 7 cases quit midway, and finally 50 cases in the observation group and 43 cases in the control group. Observation group was treated with conventional drugs + Sacubitril-Valsartan, and control group was treated with conventional drugs + Irbesartan. Both groups were followed up for 6 months. The left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), 6-min walking test distance and N-terminal probrain natriuretic peptide (NT-proBNP) were compared between the two groups before and 24 weeks after treatment. The evaluate glomerular filtration rate (eGFR), cardiac troponin T (cTnT) and growth stimulation expressed gene 2 (ST2) were compared between the two groups before treatment and 24 weeks after treatment. The treatment effect and incidence of adverse reactions were compared between the two groups. Kaplan-Meier survival analysis was used to plot survival curves to compare the rate of unplanned rehospitalization due to heart failure, cumulative risk of adverse cardiovascular events, cumulative ratio of rehospitalization costs, and all-cause mortality between the two groups. Results Before treatment, there were no statistical significances in 6-min walking test distance, NT-proBNP, LVEDD, LVEF, ST2, cTnT and eGFR between the two groups (P>0.05). After 24 weeks of treatment, the levels of NT-proBNP and LVEDD in both groups were lower than those before treatment, the levels of LVEF in both groups were higher than those before treatment, and the 6-min walking test distancese in both groups were longer than those before treatment, the differences were statistically significant (P<0.05). After 24 weeks of treatment, the levels of NT-proBNP and LVEDD in the observation group were lower than those in the control group, and the level of LVEF in the observation group was higher than that in the control group, the 6-min walking test distance in the observation group was longer than that in the control group, and the differences were statistically significant (P<0.05). After 24 weeks of treatment, ST2 and eGFR levels in observation group were higher than those in control group, while cTnT level in the observation group was lower than that in control group, the differences were statistically significant (P<0.05). After 24 weeks of treatment, the treatment effect of observation group was better than that in control group, and the total effective rate was higher than that in control group, the difference was statistically significant (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). The rate of unplanned rehospitalization due to heart failure, cumulative risk of adverse cardiovascular events, cumulative ratio of rehospitalization costs and all-cause mortality in the observation group were lower than those in the control group (P<0.05). Conclusion Sacubitril-Valsartan can significantly improve the activity tolerance and clinical symptoms of patients with chronic heart failure, and improve the glomerular filtration function, which has certain improvement on patients′ long-term prognosis.
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