Sacubitril/valsartan improves the prognosis of acute myocardial infarction: a meta-analysis.

OBJECTIVE: To systematically evaluate the effect of sacubitril/valsartan (SV) on the prognosis of patients with acute myocardial infarction (AMI), and to provide evidence for expanding the clinical application of SV.

METHODS: PubMed, EMbase, Web of Science, and Cochrane Library were searched from inception to October 2023 for randomized controlled trials (RCTs) of SV in patients with AMI. The article was screened and evaluated by the Cochrane 5.1.0 bias risk assessment tool. RevMan5.3 was used for meta-analysis of the outcome indicators.

RESULTS: Ten RCTs involving 7230 patients were included. The results showed that SV increased left ventricular eject fraction (MD = 2.86, 95% CI [1.81-3.90], P < 0.00001) and reduced readmission rate (RR = 0.46, 95% CI [0.32-0.68], P < 0.0001), decreased N-terminal pro-brain natriuretic peptide (MD = -477.46, 95% CI [-914.96 to -39.96], P = 0.03), and reduced major adverse cardiovascular and cerebrovascular event (MACCE) (RR = 0.48, 95% CI [0.27-0.85], P = 0.01). There was no significant difference in the rate of adverse reaction (AR) between the trial group and the control group (RR = 0.88, 95% CI [0.60-1.30], P = 0.52).

CONCLUSION: SV can effectively improve the prognosis of AMI, prevent complications, and there is no significant difference in safety compared with angiotensin-converting enzyme inhibitor/angiotensin receptor blocker.