Clinical effect of Shexiang Baoxin pill combined with sacubitril/valsartan in the treatment of acute myocardial infarction after percutaneous coronary intervention

Abstract

Abstract:

ObjectiveTo investigate the clinical effect of Shexiang Baoxin pill combined with sacubitril/valasrtan in the treatment of acute myocardial infarction after percutaneous coronary intervention(PCI).MethodsA total of 120 patients with acute myocardial infarction from January 2021 to November 2023 after PCI were selected and randomly assigned to observation group (60 cases) and control group (60 cases) in Chuzhou First People’s Hospital. The patients in both groups were given anticoagulation, antiplatelet, lipid-regulating, and other conventional treatment, while the control group was treated with sacubitril/valsartan, and the observation group was treated with sacubitril/valsartan combined with Shexiang Baoxin pill. The indexes including the changes of C-reactive protein(CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), blood pressure, left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD), fractional shortening(FS) rate, left ventricular ejection fraction (LVEF) were compared between the two groups. The incidence of arrhythmia and length of stay during hospitalization and the rate of re-hospitalization within six months due to adverse cardiac events were also compared between the two groups.ResultsAfter 4-week treatment, the levels of CRP and NT-proBNP in the observation group were significantly lower than those in the control group (allP<0.05). After 6-month treatment, the cardiac color ultrasound ultrasonography indexes (LVEDD, LVESD, FS, LVEF) in the observation group were better than those in the control group (allP<0.05). The incidence of atrial and ventricular arrhythmias in the observation group was lower than that in the control group duration of hospital stay (P<0.05), and length of hospitalization in the observation group was shorter than that in the control group (P<0.05). At the 6-month follow-up, the rate of rehospitalization in the observation group was lower than that in the control group (5.1%vs26.3%,P<0.05).ConclusionsThe combination of Shexiang Baoxin pill and sacubitri/valsartan can effectively inhibit inflammatory response, reverse ventricular remodeling, improve cardiac function, reduce complications and improve prognosis in patients with acute myocardial infarction after PCI.

Key words:Acute myocardial infarction,Shexiang Baoxin pill,Sacubitril/valsartan,Cardiac function

CLC Number:

R542.22

FANG Chunmei, LI Feng, SHEN Tongtong, ZHOU Yang. Clinical effect of Shexiang Baoxin pill combined with sacubitril/valsartan in the treatment of acute myocardial infarction after percutaneous coronary intervention[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(05): 310-313.

Figures/Tables4

Table 1

Comparison of general clinical baseline between the two groups[$\bar{x}\pm s$/n(%)]

项目	对照组	观察组	t/χ²	P
年龄（岁）	64.95±10.44	65.95±10.40	-0.526	0.600
男性[n（%）]	37（61.7）	39（65.0）	0.144	0.705
吸烟史[n（%）]	23（38.3）	27（45.0）	0.549	0.459
高血压[n（%）]	43（71.7）	40（66.7）	0.352	0.553
血脂异常[n（%）]	11（18.3）	12（20.0）	0.054	0.817
梗死部位[n（%）]			0.720	0.906
前壁	35（58.3）	37（61.7）
下壁后壁	16（26.7）	15（25）
侧壁	7（11.7）	5（8.3）
右心室	2（3）	3（5）

Table 1

项目	对照组	观察组	t/χ²	P
心率失常[n（%）]	8(13.3)	2（3.3）	3.927	0.048
住院时间(d)	8.28±1.58	6.73±1.55	5.416	0.000

Table 2

项目	对照组	观察组	t	P
CRP (mg/L)
治疗前	13.41±1.45	13.09±1.57	1.167	0.245
治疗后	3.97±1.43¹⁾	2.93±1.44¹⁾	3.951	0.000
NT-proBNP (pg/mL)
治疗前	1 345.13±218.15	1 420.98±219.95	-1.897	0.060
治疗后	711.96±100.10¹⁾	607.46±99.97¹⁾	5.721	0.000

Table 3

Table 4

Comparison of blood pressure and cardiac color ultrasound indexes between the two groups (n=60，$\bar{x}\pm s$)

项目	对照组	观察组	t	P
SBP（mmHg）
治疗前	131.13±4.13	132.17±4.17	-1.364	0.175
治疗后	92.87±4.39¹⁾	93.62±4.81¹⁾	-0.893	0.374
DBP（mmHg）
治疗前	92.03±4.11	91.05±4.13	1.308	0.193
治疗后	61.92±4.26¹⁾	59.92±4.17¹⁾	2.601	0.010
LVESD(mm)
治疗前	39.99±2.34	40.83±2.37	-1.955	0.053
治疗后	31.97±1.94¹⁾	28.90±2.57¹⁾	7.388	0.000
LVEDD(mm)
治疗前	57.64±1.73	57.91±1.92	-7.999	0.426
治疗后	42.48±1.59¹⁾	40.19±2.06¹⁾	6.807	0.000
FS(%)
治疗前	20.05±2.21	20.25±2.25	-0.491	0.625
治疗后	29.18±2.13¹⁾	32.10±2.28¹⁾	-7.253	0.000
LVEF(%)
治疗前	44.93±2.34	45.13±1.97	-0.520	0.604
治疗后	51.08±2.08¹⁾	52.18±1.94¹⁾	-3.001	0.003

Table 4

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