Efficacy of Sacubitril/Valsartan in the Treatment of Patients with Coronary Artery Disease Complicated by Heart Failure

Qianru XU; Songwu DONG; Rongyan Jiang

Article Contents

Article Navigation > Journal of Kunming Medical University > 2025 > Accepted Manuscript

Qianru XU, Songwu DONG, Rongyan Jiang. Efficacy of Sacubitril/Valsartan in the Treatment of Patients with Coronary Artery Disease Complicated by Heart Failure[J]. Journal of Kunming Medical University.

Citation:

Qianru XU, Songwu DONG, Rongyan Jiang. Efficacy of Sacubitril/Valsartan in the Treatment of Patients with Coronary Artery Disease Complicated by Heart Failure[J]. Journal of Kunming Medical University.

Citation:

PDF( 600 KB)

Efficacy of Sacubitril/Valsartan in the Treatment of Patients with Coronary Artery Disease Complicated by Heart Failure

Department of Cardiovascular Medicine，Bozhou People’s Hospital，Bozhou Anhui 236800，China

Received Date: 2025-05-25

Abstract

Abstract

Objective To investigate the short-term efficacy and safety of sacubitril/valsartan （S/V） in patients with coronary heart disease （CHD） complicated by heart failure （HF） during hospitalization. Methods A prospective, non-randomized, open-label controlled design was used. A total of 65 patients with CHD complicated by HF who were admitted to our hospital from January 2020 to December 2023 were enrolled. The control group （n = 33） received conventional ACEI/ARB therapy, while the treatment group （n = 32） switched to S/V after discontinuing ACEI/ARB for 36 hours. Heart function, oxidative stress markers, hemodynamic parameters, inflammatory factors, quality of life scores, and adverse reactions were observed and compared before and after 21 days of treatment. Results Compared with the control group, the treatment group showed significant improvements in left ventricular ejection fraction （LVEF）, left ventricular end-systolic diameter （LVESd）, and left ventricular end-diastolic diameter （LVEDd） after 21 days （P < 0.05）. Superoxide dismutase （SOD） levels increased, while malondialdehyde （MDA） levels decreased （P < 0.05）. Cardiac index （CI） and cardiac output （CO） increased （P < 0.05）, and serum levels of tumor necrosis factor-alpha （TNF-α）, interleukin-6 （IL-6）, and C-reactive protein （CRP） decreased （P < 0.05）. The SF-36 quality of life score significantly improved （P < 0.05）. The incidence of adverse reactions was significantly lower in the treatment group compared with the control group （P < 0.05）. Conclusion S/V can improve cardiac function, oxidative stress, hemodynamics, and inflammatory response in hospitalized patients with CHD complicated by HF in the short term.
- Coronary heart disease,
- Heart failure,
- Sacubitril/valsartan,
- Heart function,
- Oxidative stress,
- Inflammation

FullText(HTML)

References(33)

References

[1]	Savarese G, Becher P M, Lund L H, et al. Global burden of heart failure: A comprehensive and updated review of epidemiology[J]. Cardiovasc Res, 2023, 118(17): 3272-3287. doi: 10.1093/cvr/cvac013
[2]	Khan M S, Shahid I, Bennis A, et al. Global epidemiology of heart failure[J]. Nat Rev Cardiol, 2024, 21(10): 717-734. doi: 10.1038/s41569-024-01046-6
[3]	Maryam, Varghese T P, Tazneem B. Unraveling the complex pathophysiology of heart failure: Insights into the role of renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system (SNS)[J]. Curr Probl Cardiol, 2024, 49(4): 102411. doi: 10.1016/j.cpcardiol.2024.102411
[4]	Ravarotto V, Bertoldi G, Stefanelli L F, et al. Pathomechanism of oxidative stress in cardiovascularrenal remodeling and therapeutic strategies[J]. Kidney Res Clin Pract, 2022, 41(5): 533-544. doi: 10.23876/j.krcp.22.069
[5]	Houglum J E, Harrelson G L, Seefeldt T M. Drugs for treating hypertension and heart disease[M]//Principles of Pharmacology for Athletic Trainers. Routledge, 2024: 210-235.
[6]	Machado-Duque M E, Gaviria-Mendoza A, Valladales-Restrepo L F, et al. Heart failure treatment patterns: A pharmacoepidemiological descriptive study in Colombia (The HEATCO study)[J]. PLoS One, 2025, 20(6): e0325515. doi: 10.1371/journal.pone.0325515
[7]	Sutanto H, Dobrev D, Heijman J. Angiotensin receptor-neprilysin inhibitor (ARNI) and cardiac arrhythmias[J]. Int J Mol Sci, 2021, 22(16): 8994. doi: 10.3390/ijms22168994
[8]	Yamamoto K, Rakugi H. Angiotensin receptor-neprilysin inhibitors: Comprehensive review and implications in hypertension treatment[J]. Hypertens Res, 2021, 44(10): 1239-1250. doi: 10.1038/s41440-021-00706-1
[9]	Volpe M, Bauersachs J, Bayés-Genís A, et al. Sacubitril/valsartan for the management of heart failure: A perspective viewpoint on current evidence[J]. Int J Cardiol, 2021, 327: 138-145. doi: 10.1016/j.ijcard.2020.11.071
[10]	Nikolic M, Srejovic I, Jovic J J, et al. Sacubitril/valsartan in heart failure and beyond-From molecular mechanisms to clinical relevance[J]. Rev Cardiovasc Med, 2022, 23(7): 238. doi: 10.31083/j.rcm2307238
[11]	Rivera-Toquica A, Echeverría L E, Arias-Barrera C A, et al. Adherence to treatment guidelines in ambulatory heart failure patients with reduced ejection fraction in a Latin-American country: Observational study of the Colombian heart failure registry (RECOLFACA)[J]. Cardiology, 2024, 149(3): 228-236. doi: 10.1159/000535916
[12]	Samanidis G. Current challenges in diagnosis and treatment of cardiovascular disease[J]. J Pers Med, 2024, 14(8): 786. doi: 10.3390/jpm14080786
[13]	Jain A, Meyur S, Wadhwa L, et al. Effects of angiotensin receptor-neprilysin inhibitors versus enalapril or valsartan on patients with heart failure: A systematic review and meta-analysis[J]. Cureus, 2023: ■-■.
[14]	张建军. 接轨国际指南、彰显中国特色—《中国心力衰竭诊断和治疗指南2018》解读[J]. 中国临床医生杂志, 2019, 47(04): 398-402+374.
[15]	Zhang M, Zou Y, Li Y, et al. The history and mystery of sacubitril/valsartan: From clinical trial to the real world[J]. Front Cardiovasc Med, 2023, 10: 1102521. doi: 10.3389/fcvm.2023.1102521
[16]	Casale M, Correale M, Laterra G, et al. Effects of sacubitril/valsartan in patients with high arrhythmic risk and anICD: A longitudinal study[J]. Clin Drug Investig, 2021, 41(2): 169-176. doi: 10.1007/s40261-020-00995-3
[17]	Ma N, Bai L, Lu Q. First-trimester triglyceride-glucose index and triglyceride/high-density lipoprotein cholesterol are predictors of gestational diabetes mellitus among the four surrogate biomarkers of insulin resistance[J]. Diabetes Metab Syndr Obes, 2024, 17: 1575-1583. doi: 10.2147/DMSO.S454826
[18]	Altebainawi A F, AlSuhaibani S A, Alshahrani A M. Strategies to curtail the burden of cardiovascular diseases during Hajj activities: A review[J]. Saudi J Clin Pharm, 2023, 2(3): 75-78. doi: 10.4103/sjcp.sjcp_17_23
[19]	Rubattu S, Gallo G. The natriuretic peptides for hypertension treatment[J]. High Blood Press Cardiovasc Prev, 2022, 29(1): 15-21. doi: 10.1007/s40292-021-00483-5
[20]	Abboud A, Januzzi J L. Reverse cardiac remodeling and ARNI therapy[J]. Curr Heart Fail Rep, 2021, 18(2): 71-83. doi: 10.1007/s11897-021-00501-6
[21]	Rohde L E, Claggett B L, Wolsk E, et al. Cardiac and noncardiac disease burden and treatment effect of sacubitril/valsartan: Insights from a combined PARAGON-HF and PARADIGM-HF analysis[J]. Circ Heart Fail, 2021, 14(3): e008052. doi: 10.1161/CIRCHEARTFAILURE.120.008052
[22]	Murphy S P, Prescott M F, Maisel A S, et al. Association between angiotensin receptor-neprilysin inhibition, cardiovascular biomarkers, and cardiac remodeling in heart failure with reduced ejection fraction[J]. Circ Heart Fail, 2021, 14(6): e008410. doi: 10.1161/CIRCHEARTFAILURE.120.008410
[23]	Sobiborowicz-Sadowska A M, Kamińska K, Cudnoch-Jędrzejewska A. Neprilysin inhibition in the prevention of anthracycline-induced cardiotoxicity[J]. Cancers, 2023, 15(1): 312. doi: 10.3390/cancers15010312
[24]	Shi X, Dorsey A, Qiu H. New progress in the molecular regulations and therapeutic applications in cardiac oxidative damage caused by pressure overload[J]. Antioxidants, 2022, 11(5): 877. doi: 10.3390/antiox11050877
[25]	Graczyk P, Dach A, Dyrka K, et al. Pathophysiology and advances in the therapy of cardiomyopathy in patients with diabetes mellitus[J]. Int J Mol Sci, 2024, 25(9): 5027. doi: 10.3390/ijms25095027
[26]	King N E, Brittain E. Emerging therapies: The potential roles SGLT2 inhibitors, GLP1 agonists, and ARNI therapy for ARNI pulmonary hypertension[J]. Pulm Circ, 2022, 12: e12028. doi: 10.1002/pul2.12028
[27]	Xu Y, Yang B, Hui J, et al. The emerging role of sacubitril/valsartan in pulmonary hypertension with heart failure[J]. Front Cardiovasc Med, 2023, 10: 1125014. doi: 10.3389/fcvm.2023.1125014
[28]	Ráduly A P, Saman Kothalawala E, Balogh L, et al. Sacubitril/valsartan improves hemodynamic parameters of pulmonary and systemic circulation in patients awaiting heart transplantation[J]. J Clin Med, 2025, 14(8): 2539. doi: 10.3390/jcm14082539
[29]	Kuang J, Jia Z, Chong T K, et al. Sacubitril/valsartan attenuates inflammation and myocardial fibrosis in Takotsubo-like cardiomyopathy[J]. J Mol Cell Cardiol, 2025, 200: 24-39. doi: 10.1016/j.yjmcc.2025.01.003
[30]	Chaar D, Dumont B, Vulesevic B, et al. Neutrophils pro-inflammatory and anti-inflammatory cytokine release in patients with heart failure and reduced ejection fraction[J]. ESC Heart Fail, 2021, 8(5): 3855-3864. doi: 10.1002/ehf2.13539
[31]	Bunsawat K, Ratchford S M, Alpenglow J K, et al. Sacubitril-valsartan improves conduit vessel function and functional capacity and reduces inflammation in heart failure with reduced ejection fraction[J]. J Appl Physiol, 2021, 130(1): 256-268. doi: 10.1152/japplphysiol.00454.2020
[32]	Dalal J, Chandra P, Ray S, et al. Practical recommendations for the use of angiotensin receptor-neprilysin inhibitors (ARNI) in heart failure: Insights from Indian cardiologists[J]. Cardiol Ther, 2023, 12(3): 445-471. doi: 10.1007/s40119-023-00323-8
[33]	Major K, Bodys-Pełka A, Grabowski M, et al. Quality of life in heart failure: New data, new drugs and devices[J]. Cardiol J, 2024, 31(1): 156-167. doi: 10.5603/cj.92243

Relative Articles(20)

Relative Articles

[1]	Haixing ZHANG, Jingyun ZHANG, Dandan XU, Lu CAO, Jingjing LI. The Mechanism of miR-23 Regulating PI3K/AKT/mTOR Pathway to Improve Myocardial Angiogenesis in Hypertensive Heart Failure Rats. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20251105
[2]	Zhenzhen LIU, Ying ZHANG, Xinyu GAO. The Relationship between Plasma ADAMTS13 Levels and Clinical Prognosis in Heart Failure Patients with Type 2 Diabetes Mellitus. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250713
[3]	Nan HUAI, Rui LI, Guangrong SONG, Anren KUANG. Effect of Rapamycin-induced Oxidative Stress on Thyroiditis Rats. Journal of Kunming Medical University,
[4]	Shuangxiu LI, Qi ZHENG, Gaosheng YIN, Ping YANG, Lu LING. Effect of Autophagic Flux Impairment-mediated Apoptosis on Pressure Overload-induced Heart Failure. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250906
[5]	Yanping LI, Efty Fariha Tasnim, Zhixing LU, Lingying ZHU. The Role of APOE4 in Regulating LRP1 on Aβ_25-35-Induced Oxidative Stress and Inflammatory Response in Astrocytes. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20251103
[6]	Peng DING, Jia LI, Xiaodan ZHAO, Jie ZHAO, Changrong MIAO. Protective Effect of MiR-193a-5p on Cardiac Function in Rats with Chronic Heart Failure by Regulating IL-33/ST2 Signaling Pathway. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250506
[7]	Shaoyan NIE, Susu FAN, Yushan ZHU, Xuerong PENG, Yang WANG, Xuan ZHANG. Protective Effects of Xiyanping Injection on Lipopolysaccharide-induced Acute Lung Injury in Mice. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20241105
[8]	Lin CHEN, Xin NIAN, Hongyan CAI. Research Progress in the Treatment of Diabetes Mellitus with Cardiovascular Complications with Sacubitril Valsartan. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20241101
[9]	Mei YANG, Ping WANG, Hui YANG, Gonghao HE. Potential Therapeutic Targets and Research Progress of Related Drugs of Heart Failure. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230719
[10]	Yan QIU, Yinli WANG, Mengmeng YANG, Liangmin GUO, Longhui YUAN. Association between MPV，PDW，PCT and Cardiac Function in Patients with Pulmonary Hypertension. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20231219
[11]	Meng SHANG, Xiaolong GAO, Xiaohui KUANG, Xi ZHANG, Jin ZHANG, Lilin WANG. Application of Sacubitril/valsartan in Patients with Chronic Heart Failure Implanted with Implantable Cardioverter Defibrillators. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20231109
[12]	Wenqing MIAO, Yu WANG, Xiaoli ZHAO, Nini TIAN, Liying YOU. Analysis of Differential Gene Expression and Function in Peripheral Blood of Patients with Coronary Heart Disease and Acute Myocardial Infarction. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20220614
[13]	Wei-wen WANG, De-xia LI, Jie ZHANG, Lin LI. Correlation Between Serum Soluble ST2 and Cardiac Remodeling in Patients with Heart Failure with Reduced Ejection Fraction. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20210813
[14]	Li Jie , Zhang Shi Ming , Yang Shu Lian . . Journal of Kunming Medical University,
[15]	Jian-pei SU, Wei-meng TIAN, Jun GU, Mi-yu HE. Association between C-reactive Protein/Albumin Ratio and Long-term Prognosis in Elderly Patients with Heart Failure. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20201236
[16]	Zhang Ti Ling , Zhang Wei Hua , Luo Qing 祎, Xia Hong Ying , Lu Yi Bing . . Journal of Kunming Medical University,
[17]	Ye Xue Qun , Nie Lei . . Journal of Kunming Medical University,
[18]	Wang Yu . . Journal of Kunming Medical University,
[19]	Chang Song Jie . . Journal of Kunming Medical University,
[20]	Yan Qing Feng . Effects of Luteolin on Isolated Heart Function and Oxidative Stress Reaction after Hypothermic Preservation. Journal of Kunming Medical University,