Protective effect of sacubitril/valsartan in patients with acute myocardial infarction: A meta‑analysis

• Published in: Experimental and therapeutic medicine Vol. 23; no. 6; p. 406
• Main Authors: Liu, Shanshan, Yin, Bi, Wu, Bo, Fan, Zhixing
• Format: Journal Article
• Language: English
• Published: Greece Spandidos Publications 01.06.2022; Spandidos Publications UK Ltd; D.A. Spandidos
• Subjects: Bias; Development and progression; Drug dosages; Drug therapy; Enzymes; Heart attack; Heart attacks; Heart failure; Hypotension; Intervention; Management; Medical Subject Headings-MeSH; Meta-analysis; Mortality; Patient outcomes; Patients; Peptides; Secondary data analysis; Sodium; Software; Stroke; Valsartan; China; meta-analysis; safety; acute myocardial infarction; efficacy; sacubitril/valsartan
• ISSN: 1792-0981; 1792-1015
• DOI: 10.3892/etm.2022.11333

To evaluate the effects and safety of sacubitril/valsartan in patients with acute myocardial infarction (AMI), a total of four databases, including PubMed, Cochrane Library, Embase and Web of Science, and the ClinicalTrials.gov website were searched. Using a combination of medical subject headings and entry terms, the final search was performed in July 2021. A manual search of cross-references from the original articles was also conducted. The meta-analysis was subsequently performed with Revman 5.3 software and a total of four studies comprising 586 patients were included. The results disclosed a significant reduction in major adverse cardiovascular and cerebrovascular events (MACCEs) [odds ratio (OR), 0.47; 95% confidence interval (CI), 0.30-0.73; P=0.0007], readmission (OR, 0.45; 95% CI, 0.29-0.71; P=0.0006), incidence of acute heart failure (AHF) (OR, 0.45; 95% CI, 0.28-0.71; P=0.0007) and N-terminal pro B-type natriuretic peptide [standardized mean difference (SMD), -0.88; 95% CI, -1.55-(-0.21); P=0.01] in the sacubitril/valsartan group compared with that in the control group, and a random effects model was used to pool these data. No significant differences were identified in the incidence of hypotension (OR, 2.91; 95% CI, 0.55-15.51; P=0.21), adverse events (OR, 2.19; 95% CI, 0.42-11.37; P=0.35), left ventricular ejection fraction (mean difference, 1.96; 95% CI, -0.84-4.76; P=0.17) or soluble suppression of tumorigenesis-2 (SMD, -0.45; 95% CI, -1.62-0.71; P=0.45) according to the random effects model. In conclusion, the present meta-analysis revealed that sacubitril/valsartan was able to effectively reduce the incidence of MACCEs, readmission and AHF in patients with AMI after revascularization without any obvious adverse events.