Effect Sacubitril/Valsartan in patients with Acute Myocardial Infarction (AMI): a systematic review and meta-analysis

Abstract

Background: Acute Myocardial Infarction (AMI) is a type of coronary heart disease with high morbidity and mortality. The renin-angiotensin-aldosterone system (RAAS) is an important endocrine system in controlling blood pressure and cardiovascular homeostasis and is responsible for AMI. In patients with AMI or a heart attack, sacubitril/valsartan has been shown to reduce the risk of heart failure and death. This study aims to evaluate the effect of sacubitril/valsartan in AMI patients. Methods: In order to evaluate the effects of sacubitril/valsartan in patients with AMI, three databases, including PubMed, Cochrane Library, and the ClinicalTrials website, were searched. The final search was performed in January 2023. The meta‑analysis was subsequently performed with Revman 5.4 software and a total of three studies were included. Results: The results of the main outcomes showed that sacubitril/valsartan has no significant reduction in major adverse cardiovascular and cerebrovascular events (MACCEs) odds ratio (OR), 0.70; 95% confidence interval (CI), 0.38‑1.30; P=0.26] and incidence of acute heart failure (AHF) (OR, 0.52; 95% CI, 0.24‑1.15; P=0.11). The secondary outcomes showed no effect of sacubitril/valsartan to increase left ventricular remodeling. Conclusion: In conclusion, the present meta‑analysis revealed that sacubitril/valsartan could not effectively reduce the incidence of MACCEs and AHF in patients with AMI. In the future, a meta‑analysis study will be designed with many studies to reduce the incidence of MACCEs and AHF effectively.