STEMI
Conditions
Interventions
if ACEI intolerance occurs, valsartan may be used.
Test group (randomized): Sacubitril/Valsartan:The experimental group was administered sacubitril valsartan.
Control group (randomized): ACEI/ARB:The control group received benazepril
Sponsors
General Hospital of the Northern Theater Command, People's Liberation Army, No.83 Wenhua Road, Shenhe District, Shenyang City, Liaoning Province
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Must meet all the following criteria: 1) Age >= 18 years; 2) Patients with acute ST-segment elevation myocardial infarction (STEMI) who have their first episode and successfully undergo interventional therapy within 48 hours after onset. 3) Successful complete revascularization was achieved. (Definition of successful revascularization requires: (a) reduction of the minimum stenotic diameter of the culprit vessel to 20%; (b) treatment of all lesions with stenosis >= 70%; (c) TIMI grade 3 flow as assessed by angiography.) 4) Echocardiographic evaluation confirmed a left ventricular ejection fraction (LVEF) >= 40%; 5) Hemodynamic stability, defined as meeting the following criteria: For patients who received ACEI/ARB therapy within the past 24 hours, systolic blood pressure (SBP) >= 100 mmHg; For patients not receiving ACEI/ARB therapy, systolic blood pressure (SBP) >= 110 mmHg; Did not add intravenous diuretics or vasodilators; Has not used vasopressin and/or positive inotropic drugs within the past 24 hours. 6) Voluntary signing of the informed consent form.
Exclusion criteria
Exclusion criteria: Meets one of the following criteria: 1) Severe heart failure (NYHA Class IV, requiring intravenous positive inotropic drug support); 2) History of traumatic cerebral infarction, myocardial infarction, or previous revascularization procedures (including PCI, PTCA, CABG, implantation of ventricular assist devices, or heart transplantation); 3) Patients with left ventricular systolic dysfunction, cardiomyopathy (idiopathic hypertrophic cardiomyopathy, myocarditis, pericarditis, or active infection, etc.), primary valvular heart disease (moderate to severe), congenital heart disease, or those scheduled for cardiac surgery within 3 months; 4) Severe hepatic insufficiency (alanine aminotransferase (ALT) or aspartate aminotransferase (AST)> 3 times the upper limit of normal); 5) History of chronic renal impairment or eGFR 5.5 mmol/L); 6) Allergy or contraindication to the drugs used in this study; 7) The myocardial infarction (MI) location is acute inferior wall with right ventricular involvement, or acute inferior wall MI with right ventricular involvement. 8) Known to have malignant tumors or severe progressive diseases (e.g., active autoimmune disease, acute paroxysmal asthma/chronic obstructive pulmonary disease, or severe infections), with a projected survival period <12 months 9) Severe anemia (hemoglobin <10 g/dL) or platelet count <100×10^9/L; 10) Women who are pregnant or breastfeeding, or who plan to become pregnant; 11) Death during hospitalization; 12) Mental disorders, alcohol or drug abuse; 13) History of angioedema associated with prior ACEI/ARB therapy; 14) Lack of willingness for interventional therapy or poor compliance with anticipated clinical studies; 15) Participation in other ongoing clinical studies or any circumstances where the investigator deems the individual unsuitable for this study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| LVESV;LVEDV; | — |
Secondary
| Measure | Time frame |
|---|---|
| NT- proBNP; | — |
Countries
China
Contacts
Public Contactwangxiaozeng
General Hospital of the Northern Theater Command of the Chinese People's Liberation Army
Outcome results
None listed