AIM  To explore the clinical efficacy and safety of sacubitril valsartan following percutaneous coronary intervention (PCI) for patients with acute myocardial infarction (AMI).

  METHODS  Seventy-six patients with AMI admitted to the Second Affiliated Hospital of Air Force Medical University from September 2019 to October 2020 were selected as the study subjects. Postoperatively, they were assigned, using a block randomization, non-blind and positive-controlled method, to the valsartan treatment group (control group, n = 38) and sacubitril valsartan treatment group (observation group, n = 38). At 3 months of treatment, the primary endpoints including cardiac ultrasound indicators and incidence of major adverse cardiovascular events (MACEs), the secondary endpoints and the safety indicators were compared between the two groups.

  RESULTS  Post-treatment left atrial diameter (LAd), left ventricular end diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), blood pressure and NT-proBNP showed statistically significant decreases from those pre-treatment in the observation group (P<0.05). The observation group was superior over the control group in reducing LAd, LVEDV and LVESV and inhibiting ventricular remodeling, with statistically significant differences (P<0.05). Post-treatment 6-minute walk distance (6MWD) showed statistically significant changes from that pre-treatment in both groups (P<0.05) and statistically significantly greater improvement in the observation group than that in the control group (P<0.05). There were no statistically significant differences between the two groups in the incidence of adverse drug reactions or MACEs.

  CONCLUSIONS  For patients with AMI, sacubitril valsartan acts earlier and more efficaciously than valsartan in inhibiting ventricular remodeling and preventing heart failure, with favorable safety profile in clinical application, which provides clinical evidences for the application of sacubitril valsartan in patients with AMI. This conclusion requires to be further investigated in large studies.