Comparison of sacubitril valsartan and valsartan in treatment of chronic heart failure in the elderly

Sun Huamei; Dai Yanan; Zhou Qiang; Wang Dan

doi:10.3969/j.issn.1009-0126.2024.12.004

Abstract：Objective To explore the application value of sacubitril valsartan versus valsartan in the treatment of chronic heart failure(CHF)in the elderly patients based on the changes in serum heat shock protein 27(HSP27)and soluble glycoprotein 130(sgp130)levels.Methods A total of 204 CHF patients admitted to our hospital from June 2021 to December 2023 were retrospectively enrolled and divided into Group A(sacubitril valsartan,102 cases)and Group B(valsartan,102 cases).The clinical efficacy and cardiac function grade after 6 months of treatment were compared between the two groups.The changes in the serum levels of HSP27,sgp130,NT-ProBNP as well as echocardiographic indicators before and after treatment,and incidence of cardiovascular events were recorded and compared.Results After treatment,Group A obtained significantly higher total clinical efficacy and larger proportion of better NYHA grades than Group B(P＜0.05).After treatment,the serum levels of HSP27,sgp130 and NT-proBNP and values of LVEDD,LVPWT and IVST were significantly reduced in both groups,with more obviously decreased indi-cators in Group A(P＜0.01).What's more,LVEF and cardiac output were increased in both groups after treatment,and those in Group A were notably higher than those in Group B[(55.47±5.27)％vs(52.70±5.08)％,4.97±0.26 L/min vs 4.61±0.16 L/min,P＜0.01].The incidences of myocardial infarction and total cardiovascular events were remarkably lower in Group A than Group B(0.98％vs 6.86％,P=0.030;8.82％vs 18.63％,P=0.042).Conclusion In elderly CHF patients,sacubitril valsartan is superior to valsartan in more effectively regulating serum HSP27 and sgp130 levels,reversing the ventricular remodeling,and improving the cardiac function.