Effect of angiotensin receptor enkephalase inhibitors on cardiac function in patients with acute myocardial infarction complicated with diabetes mellitus
Objective To investigate the effect of angiotensin receptor enkephalase inhibitors(ARNI)on cardiac func-tion in patients with acute myocardial infarction(AMI)complicated with diabetes.Methods Totally 100 patients with AMI complicated with diabetes admitted from January 2020 to December 2022 were randomly divided into ARNI group and conventional group with 50 patients in each group.Both groups received emergency PCI and postoperative adminis-tration of antiplatelet and blood glucose control drugs,while ARNI group also received nohintal on the basis of this treat-ment.The clinical effective rate after 2 months of treatment,cardiac function indexes,myocardial injury and inflamma-tion indexes,hemorheology indexes and the incidence of cardiovascular adverse events were compared between the two groups.Results The effective rate of ARNI group(90.00％)was higher than that of conventional group(74.00％)(P＜0.05).After treatment,the left ventricular ejection fraction in ARNI group(60.24±5.26)％was higher than that in conventional group(55.72±4.93)％.Ventricular septal thickness(7.34±1.37)mm and left ventricular end-diastolic diameter(44.95±3.59)％were lower than those in conventional group(9.26±1.75)mm,(48.57± 4.82)％(P＜0.05).In ARNI group,troponin Ⅰ(1.53±0.94)ug/L,hypersensitive troponin Ⅰ(3.96±1.48)ng/mL,amino-terminal brain natriuretic peptide precursor(737.83±315.24)pg/mL and hypersensitive C-reactive pro-tein(10.73±3.24)pg/mL were detected,interleukin-8(68.25±21.85)pg/mL and interleukin-17(8.37± 3.28)ng/L were lower than those in conventional group[(2.84±1.24)ug/L,(5.28±1.39)ng/mL,(1 342.84± 535.82)pg/mL,(14.74±2.95)ng/mL,(84.62±19.69)pg/mL,1(3.85±4.19)ng/L](P＜0.05);After treat-ment,whole blood low tangential viscosity(9.24±1.33 mpa/s),whole blood high tangential viscosity(4.97±0.52)mpa/s,fibrinogen(2.88±0.53)g/L and D-dimer(0.35±0.13)mg/L in ARNI group were lower than those in con-ventional group[(10.62±1.47)mpa/s,(5.37±0.55)mpa/s,(3.53±0.64)g/L,(0.68±0.21)mg/L](P＜0.05);Cardiovascular adverse events occurred in 5 cases(10.00％)in ARNI group,compared with 14 cases(28.00％)in conventional group(P＜0.05).Conclusion In AMI patients with diabetes after PCI,ARNI can im-prove clinical efficacy,improve cardiac function,reduce myocardial damage,inhibit inflammation,improve hemorheolo-gy indexes,and reduce cardiovascular adverse events.
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