{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:54:40Z","timestamp":1780451680253,"version":"3.54.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":639,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T00:00:00Z","timestamp":1705276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study sought to assess the effect of treatment of sacubitril\/valsartan (S\/V) on improving cardiac function and reversing cardiac remodelling in patients with acute coronary syndrome (ACS) complicated with heart failure with reduced ejection fraction after percutaneous coronary intervention (PCI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We enrolled 275 ACS patients with reduced left ventricular ejection fraction after PCI. The patients were divided into the routine and S\/V groups according to the treatment drugs. The symptoms, N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations, echocardiographic parameters [left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), left ventricular end-diastolic volume index (LVEDVI), and left ventricular end-systolic volume index (LVESVI)], major adverse cardiac events (MACEs), and adverse reactions were recorded at baseline and 6 months after treatment when a clinical follow-up was performed. The S\/V group was further divided into prespecified subgroups including unstable angina (UA) group, non-ST-elevation myocardial infarction (NSTEMI) group, and ST-elevation myocardial infarction (STEMI) group according to the type of ACS. We analysed the changes in LVEF, LVMI, LVEDVI, LVESVI, and NT-proBNP in both groups and evaluated the correlation between the changes in the above variables (\u0394LVEF, \u0394LVMI, \u0394LVEDVI, \u0394LVESVI, and \u0394NT-proBNP). Cox regression model was used to assess the independent risk factors of MACE. Prespecified subgroup analyses were also conducted. Compared with baseline, LVEF increased significantly (P &amp;lt; 0.05), NT-proBNP, LVMI, and LVESVI decreased significantly in both groups after 6 months (P &amp;lt; 0.05), and LVEDVI decreased significantly in the S\/V group (P = 0.001). In the S\/V group, \u0394LVEF (t = \u22122.745, P = 0.006), \u0394NT-proBNP (P = 0.009), \u0394LVEDVI (t = 4.203, P = 0.001), and \u0394LVESVI (t = 3.907, P = 0.001) were significantly improved than those in the routine group. In the S\/V group, \u0394LVEF was negatively correlated with \u0394NT-proBNP (r = \u22120.244, P = 0.004), \u0394LVMI (r = \u22120.190, P = 0.028), \u0394LVEDVI (r = \u22120.173, P = 0.045), and \u0394LVESVI (r = \u22120.261, P = 0.002). In Cox regression model analysis, \u0394LVEF {hazard ratio [HR] = 0.87 [95% confidence interval (CI) 0.80\u20130.95], P = 0.003}, \u0394LVEDVI [HR = 1.04 (95% CI 1.01\u20131.06), P = 0.013], and \u0394LVESVI [HR = 1.04 (95% CI 1.01\u20131.08), P = 0.026] were independent risk factors for MACE. Subgroup analysis showed that \u0394LVEF (t = 6.290, P = 0.001), \u0394LVEDVI (t = 2.581, P = 0.011), and \u0394NT-proBNP (P = 0.019) in the NSTEMI group were significantly improved than those in the UA group, \u0394LVEDVI in the NSTEMI group was significantly better than that in the STEMI group (t = \u22123.365, P = 0.001), and \u0394LVEF in the STEMI group was significantly better than that in the UA group (t = \u22123.928, P = 0.001). There was a significant difference in the survival probability without MACE among the three groups in the analysis of the Kaplan\u2013Meier curve (P = 0.042). The incidence of MACE in the UA group was significantly higher than that in the NSTEMI group (32.4% vs. 6.3%, P = 0.004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The cardiac function is improved and cardiac remodelling is reversed significantly after treatment of S\/V in ACS patients with reduced left ventricular ejection fraction after PCI, and the improvement is more obvious than the routine group. There is a significant negative correlation between the change in LVEF and the changes in NT-proBNP, LVMI, LVEDVI, and LVESVI. The increase of LVEF and the decrease of LVEDVI and LVESVI are protective factors to improve the prognosis. Patients with myocardial infarction and reduced left ventricular ejection fraction might benefit more from the initiation of S\/V as first-line heart failure treatment after PCI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14646","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T19:33:55Z","timestamp":1705347235000},"page":"937-949","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Improved Heart Function and Cardiac Remodelling Following Sacubitril\/Valsartan in Acute Coronary Syndrome with HF"],"prefix":"10.1093","volume":"11","author":[{"given":"Henan","family":"Liu","sequence":"first","affiliation":[{"name":"Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital , Beijing ,","place":["China"]},{"name":"The 305 Hospital of PLA , Beijing 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