沙库巴曲缬沙坦与厄贝沙坦治疗慢性心力衰竭的临床效果比较

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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.

Key words： Irbesartan Sacubitril-Valsartan Heart failure Adverse reaction 6-min walking test

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	WU Nandi
	FANG Hui

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WU Nandi,FANG Hui. Clinical effect comparison of Sacubitril-Valsartan and Irbesartan in the treatment of chronic heart failure[J]. 中国当代医药, 2022, 29(20): 14-19转25.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I20/14

[1]	Ponikowski P，Voors AA，Anker SD，et al.2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure；The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology （ESC） Developed with the special contribution of the Heart Failure Association （HFA） of the ESC[J].Eur Heart J，2016，37（27）：35-36.
[2]	杨杰孚，张健，韩雅玲，等.中国心力衰竭诊断和治疗指南2018[J].中华心血病杂志，2018，46（10）：760-789.
[3]	Zhang Y，Zhang J，Butler J，et al.Contemporary epidemiology，management，and outcomes of patients hospitalized for heart failure in China：results from the China heart failure （China·HF） registry[J].J Card Fail，2017，23（12）：868-875.
[4]	Konstam MA，Neaton JD，Dickstein K，et al.Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure （HEAAL study）：a randomized.Double-blind trial[J].Lancet，2009，374（4）：1840-1848.
[5]	Sennt M，Mcmurray JJ，Wachter R，et al.Initiating sacubitril/valsartan （LCZ696） in heart failure：results of TITRATION，a double-blind，randomized comparison of two uptitration regimens[J].Eur J Heart Fail，2016，18（9）：1193-1202.
[7]	谢诚，叶静，缪丽燕.61例心力衰竭患者血管紧张素受体脑啡肽酶抑制剂沙库巴曲缬沙坦的应用分析[J].中国药房，2019，30（8）：1124-1127.
[8]	中华医学会心血管病学分会心力衰竭学组，中国医师协会心力衰竭专业委员会，中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志，2018，46（10）：760-789.
[9]	张苏慧，方理刚.心率控制在心力衰竭患者中的临床意义及研究进展[J].中国全科医学，2019，22（12）：1492-1496.
[6]	Almufleh A，Marbach J，Chih S，et al.Ejection fraction improvement and reverse remodeling achieved with Sacubitril/Valsartan in heart failure with reduced ejection fraction patients[J].Am J Cardiovasc Dis，2017，7（6）：108-113.
[10]	Parati G，Esler M.The human Sympathetic Nervous system：Its relevance in hypertension And heart failure[J].Eur Heart J，2012，33（9）：1058-1066.
[11]	Volpe M，Carnovali M，Mastromarino V.The natri-retic peptides system in the pathophysiology of heart failure：From molecular basis to treatmen[J].Clin Sci （Lond），2015，130（2）：57-77.
[12]	Ambrosy AP，Mentz RJ，Fiuzat M，et al.The role of angiotensin receptor-neprilysin inhibitors in cardiovas-cular disease-existing evidence，knowledge gaps，and future directions[J].Eur J Heart Fail，2018，20（6）：963-972.
[13]	Mcmurray JJ，Packer M，Desai AS，et al.Angiotensin-Neprilysin Inhibition versus Enalapril in Heart Failure[J].Neng J Med，2014，371（11）：993-1004.
[14]	Volpe M，Tocci G，Battistoni A，et al.Angiotensin Ⅱ Receptor Blocker Neprilysin Inhibitor （ARNI）：NewAvenues in Cardiovascular Therapy[J].High Blood Press Cardiovasc Prev，2015，22（3）：241-246.
[15]	Mogensen UM，Kber L，Kristensen SL，et al.The effects of sacubitril/valsartan on coronary outcomes in PARADIGM-HF[J].Am Heart J，2017，188（10）：35-41.
[16]	B■hm M，Young R，Jhund PS，et al.Systolic blood pressure，cardiovascular outcomes and efficacy and safety of sacubitril/valsartan （LCZ696） in patients with chronic heart failure and reduced ejection fraction：results from PARADIGM-HF[J].Eur Heart J，2017，38（15）：1132-1143.
[17]	DeVore AD, Braunwald E, Morrow DA，et al.Initiation of Angiotensin-Neprilysin Inhibition After Acute Decompensated Heart Failure.Secondary Analysis of the Open-label Extension of the PIONEER-HF Trial[J].JAMA Cardiol，2020，5（2）：202-207.
[18]	Akshay S，Desai，Scott D，et al.Effect of Sacubitril-Valsartan vs. Enalapril on Aortic Stiffness in Patients With Heart Failure and Reduced Ejection Fraction：A Randomized Clinical Trial[J].JAMA，2019，17（11）：1077-1084.
[19]	James L，Januzzi Jr，Margaret F，et al.Association of Change in N-Terminal Pro-B-Type Natriuretic Peptide Following Initiation of Sacubitril-Valsartan Treatment With Cardiac Structure and Function in Patients With Heart Failure With Reduced Ejection Fraction[J].JAMA，2019，17（11）：1085-1095.
[20]	McMurray JJ，Packer M，Desai AS，et al.Angiotensin-neprilysin inhibition versus enalapril in heart failure[J].N Engl J Med，2014，371（11）：993-1004.