Efficacy of Angiotensin Receptor-Neprilysin Inhibitor Combined with Enhanced External Counterpulsation After Percutaneous Coronary Intervention and Its Impact on Non-invasive Hemodynamic Parameters and Readmission Rate
Objective:To investigate the efficacy of angiotensin receptor-neprilysin inhibitor(ARNI)combined with enhanced external counterpulsation(EECP)after percutaneous coronary intervention(PCI)and its impact on non-invasive hemodynamic parameters and readmission rate.Methods:One hundred pa-tients with acute anterior myocardial infarction who successfully underwent emergency PCI treatment at the De-partment of Cardiology,Shandong First Affiliated Hospital of Shandong University from October 2022 to March 2024 were randomly divided into a trial group and a control group(50 patients each).The trial group received ARNI combined with EECP treatment,and the control group received angiotensin-converting enzyme inhibitor(ACEI)treatment.The two groups were compared in terms of cardiac function,quality of life scale(SF-36),hemodynamic parameters,and readmission rate.Results:Before treatment,there was no significant difference in cardiac function and hemodynamic parameters between the two groups(P＞0.05).After 7 weeks of treatment,the levels of LVEDV,LVESV,NT-proBNP,ET-1,heart rate,SBP,DBP,RS,and CMR were decreased,while LVEF,CO,CI,LSI,LCI,AC,and COM were increased in both groups compared to before treatment(P＜0.05).The magnitude of change was greater in the trial group than in the control group,and there was a significant difference between the two groups in these parameters(P＜0.05).At 6-month fol-low-up,LVEDV,LVESV,NT-proBNP,ET-1,heart rate,SBP,DBP,RS,and CMR continued to de-crease,while LVEF,CO,CI,LSI,LCI,AC,and COM continued to increase.However,the magnitude of change was smaller,and there was still a significant difference between the two groups in these parameters(P＜0.05).Before treatment,there was no significant difference in the scores of physical function,physical function,emotional function,daily activities,mental health,overall health,social function,and physical pain on the SF-36 between the two groups(P＞0.05).After 7 weeks of treatment,the scores of all of these i-tems increased compared to before treatment(P＜0.05),and the magnitude of change was greater in the trial group than in the control group.There was also a significant difference between the two groups in these items(P＜0.05).At 6-month follow-up,the scores of these items continued to increase,but the magnitude of change was smaller.There was still a significant difference between the two groups in these items(P＜0.05).The total major adverse cardiovascular event(MACE)-related readmission rate at 6 months after treatment was significantly different between the two groups(x2=9.502,P=0.002).There was no significant differ-ence in the readmission rate due to recurrent myocardial infarction or angina pectoris(x2=0.340,P=0.560;x2=2.152,P=0.142),but the readmission rate due to heart failure was significantly different(x2=6.353,P=0.012).Conclusion:ARNI combined with EECP after PCI can improve cardiac function and patient health status,reduce resistance,reduce the incidence of adverse reactions after surgery,and thus reduce the readmission rate.
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