Effects of Evolocumab combined with Sacubitril/Valsartan in treatment of patients with acute myocardial infarction
Objective:To observe effects of Evolocumab combined with Sacubitril/Valsartan in treatment of patients with acute myocardial infarction(AMI).Methods:The clinical data of 62 patients with AMI admitted to this hospital from September 2020 to July 2023 were retrospectively analyzed.According to different treatment options,they were divided into control group(n=31)and study group(n=31).The control group was treated with Sacubitril/Valsartan,while the study group was treated with Evolocumab on the basis of that of the control group.The clinical efficacy,the levels of cardiac function indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD)],myocardial injury markers[cardiac troponin T(cTnT),N-terminal pro-brain natriuretic peptide(NT-proBNP)],vascular endothelial function indexes[endothelin-1(ET-1),nitric oxide(NO),angiotensin-Ⅱ(Ang-Ⅱ)]and inflammatory indexes[soluble intercellular adhesion molecule-1(sICAM-1),lipoprotein phospholipase(Lp-PLA2)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 93.55％(29/31),which was higher than 74.19％(23/31)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of LVEDD and LVESD in the two groups were lower than those before the treatment,and those in the study group were lower than those the control group;the LVEF levels of the two groups were higher than those before the treatment,and that in the study group was higher than that in the control group;and the difference was statistically significant(P<0.05).The levels of cTnT and NT-proBNP in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of ET-1 and Ang-Ⅱ in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;the levels of NO in the two groups were higher than those before the treatment,and that in the study group was higher than that in the control group;and the differences were statistically significant(P<0.05).The levels of sICAM-1 and Lp-PLA2 in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Evolocumab combined with Sacubitril/Valsartan in the treatment of the AMI patients can improve the total effective rate of treatment,improve the levels of cardiac function indexes and vascular endothelial function indexes,and reduce the levels of myocardial injury markers and inflammatory indexes.Moreover,it is superior to simple Sacubitril/Valsartan treatment.
万方数据
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