Safety and efficacy of sacubitril/valsartan vs. benazepril administered as initial treatment for STEMI patients with mid-range ejection fraction: a propensity score matching analysis - Scorecard - MDSpire
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Safety and efficacy of sacubitril/valsartan vs. benazepril administered as initial treatment for STEMI patients with mid-range ejection fraction: a propensity score matching analysis
Clinical Scorecard: Comparative Analysis of Safety and Effectiveness of Sacubitril/Valsartan versus Benazepril as Initial Therapy in STEMI Patients with Mid-Range Ejection Fraction: A Propensity Score Matched Study
At a Glance
Category
Detail
Condition
ST-segment elevation myocardial infarction (STEMI) with mid-range left ventricular ejection fraction (LVEF, 40%–49%)
Key Mechanisms
Sacubitril/valsartan (S/V) inhibits the renin-angiotensin-aldosterone system (RAAS) and enhances the natriuretic peptide system.
Target Population
STEMI patients with mid-range LVEF (40%–49%)
Care Setting
Second Hospital of Hebei Medical University
Key Highlights
S/V showed greater reduction in left ventricular end-systolic volume (LVESV) compared to benazepril.
S/V improved left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) more than benazepril.
No significant differences in major adverse cardiac events (MACE) or safety outcomes between S/V and benazepril.
Guideline-Based Recommendations
Diagnosis
Diagnosis of STEMI according to universal myocardial infarction definition guidelines.
Management
Initiate S/V within 24 hours of symptom onset after successful reperfusion.
Monitoring & Follow-up
Echocardiographic parameters assessed at baseline and 1-month follow-up.
Risks
No contraindications to S/V or benazepril.
Patient & Prescribing Data
Patients aged >18 years with first STEMI event and LVEF of 40%–49%.
S/V started at 25 mg twice daily, uptitrated to 50–100 mg if tolerated; benazepril started at 5 mg once daily, uptitrated to 10 mg if tolerated.
Clinical Best Practices
Concomitant guideline-directed medical therapy (GDMT) initiated within 24 hours when clinically indicated.
